PIETERMARITZBURG, South Africa””mdash;Philile Ntuli sees the
effects of HIV/AIDS every time she goes home.
A third-year English and politics student at the University of
KwaZulu-Natal in Pietermaritzburg, Ntuli is a resident of Clermont,
a township near the port city of Durban. She says almost every week
in Clermont there is at least one funeral for someone who has died
of AIDS.
“I know I’m going to get a phone call saying
so-and-so passed away, and I know it’s AIDS,” she
said.
Ntuli lost her seven year-old niece in mid-October to the
illness. Two weeks later, one of her many sisters died from it.
Ntuli has more family members than she can count, and she predicts
80 percent of them are HIV positive.
“When you know that 80 percent of your family is infected,
and your friends, the people you grew up with, it’s like your
past is slowly disappearing,” she said.
There are millions of people like Ntuli in South Africa, people
whose lives have been affected in some way by HIV/AIDS. Even though
South Africa is one of the most developed countries in Africa, it
also faces one of the biggest AIDS crises in the world.
The United Nations has estimated that at the end of 2003, 21.5
percent of adults in South Africa were HIV positive. Last year, an
estimated 370,000 people died of AIDS in this country.
It is the nightmare that will not leave the country alone.
According to some doctors, there are an estimated 1,700 new HIV
infections in South Africa every day.
Statistics like that can boggle the mind, but Ntuli knows how
close they hit home.
“When almost everyone around you has AIDS, you ask
yourself, “˜What’s going to happen? Who’s going to
be here in five years?'” she said.
University officials say there are no statistics of the HIV/AIDS
infection rate among the student body at the Pietermaritzburg
campus because no one has done a comprehensive survey.
But according to the campus AIDS Program, a study undertaken in
1999 projected 14 percent of the student body would be HIV positive
in 2004, which is the figure the campus uses for planning
purposes.
The fact that many university students are away from home for
the first time and more prone to experimentation with sex and drugs
can make them susceptible to HIV/AIDS.
But students are also generally more educated about the epidemic
as well, says Emily Mabusela, the coordinator of the campus
HIV/AIDS support unit, which coordinates programs that deal with
HIV/AIDS.
Mabusela estimates that the infection rate among the student
body probably mirrors the infection rate in the rest of South
Africa.
“It shouldn’t be any less,” she said. “A
lot of people would like to think it’s less, I don’t
know why.”
But Mabusela also points out that at the rate the virus is
spreading, the most pressing concern isn’t how many people
are infected, but rather how they should cope with it.
“The question they ask is: if there is an elephant in your
house, do you ask how big he is, or do you ask how to get him
out?” she said.
When asked whether she knew anyone who had died of AIDS, she
shrugged.
“It’s hard not to,” she said.
* * *
Sit down in the waiting room of the university health clinic and
you see signs of how heavily HIV/AIDS weighs on minds here.
On the whitewashed wall next to the receptionist desk, flyers
taped there declare that HIV Voluntary Counselling and Testing will
not be given during finals. Across the room there is a condom
dispenser. Walk down the hallway and you come across huge diagrams
that look like they’re straight out of a biology textbook
which show how HIV/AIDS infects the body.
Through a door to the right just outside the waiting room is the
office of Sister Rose Meyer, the campus HIV/AIDS counsellor. It is
cool inside, even though outside it is a balmy summer day. Meyer is
all smiles and seems almost grandmotherly ““ a good thing
because she does a lot of comforting in this office.
It is here that one of South Africa’s countless battles
against AIDS is fought on a daily basis.
A trained nurse, Meyer does all the HIV/AIDS testing for the
over 8,000 students and staff at UKZN, Pietermaritzburg. She is
always there when students finds out whether they are HIV
positive.
“I’m disclosure one,” she said while sitting
in one of her office’s comfortable chairs.
Meyer pulls a bucket stamped with biohazard symbols out from
under her desk. This is where she stores used needles and test
strips. “You don’t want to reach in there,” she
remarks as she fishes about inside with a pair of tongs and pulls
out a test strip of a student who tested negative and one who
tested positive.
She describes how she administers voluntary counseling and
testing: students must book appointments in advance. She talks with
them beforehand, educating them about the virus and asking them if
they are sure they are ready.
If they answer yes, she administers the test, a pin-prick that
draws a drop of blood which she tests for signs of HIV antibodies.
It takes 10 minutes to get the results.
Students always have a chance to leave before those 10 minutes
are up.
“One student, he left and didn’t ever come
back,” she remembers.
Meyer always reads the results with the student. If a student
tests positive, she does two follow-up tests to be certain of the
results.
The ones who test negative cry more than the ones who test
positive, out of sheer relief. Those who test positive usually go
through a process Meyer likens to “shell-shock”:
they’re fine the day of the test, but it’s the day
after when they need support.
“The next day they come with their fears and worries,
because you could imagine they’ve had all night to think
about it,” she said.
For those who test positive, Meyer takes on the role of
counselor and psychologist. She advises them on their eating
habits, how to spend their free time, how to break the news to
their family. She can see a student who has recently tested
positive three to five times a month, and sees all her HIV-positive
students at least once a month.
She urges students who are HIV-positive to continue pursuing
their degrees, even though they are planning for a future that may
never come.
With a degree, they can get higher-paying jobs out of college
and afford HIV treatment when it becomes necessary.
She also monitors their blood cell count and can recommend
antiretroviral treatment if it slips too low.
The hardest time for her, she says, is when the blood cell
counts come back for the first time, because then she can see the
student calculate how long they have left to live ““ and
possibly work out who infected them.
“And even though they say: “˜It doesn’t matter,
I have to move forward,’ I think it does matter,” she
said.
“It’s exhausting … emotionally exhausting. But
it’s rewarding. I always say to the student, “˜I cannot
hold the burden with you, but I’m walking your path with you,
I’ll hold your hand for the duration.'”
“They need to know I’m just a crutch,” she
adds.
The number of students who test HIV-positive on campus is
“incredibly low,” in Meyer’s words. Last year,
out of all the students who underwent an HIV test at all five UKZN
campuses, only 6 percent tested positive.
But this does not include students who are tested off campus, or
students who don’t get tested at all.
“By virtue of the fact that we have the most
sexually-active age group on campus, it has to be higher than 6
percent,” Meyer said.
Not a five minute walk from Meyer’s office is another
front in the war on AIDS. From her office on the top floor of the
student union, Mabusela runs projects on campus about HIV/AIDS and
does outreach to the Pietermaritzburg community.
Recently, students helped repaint an orphanage and brought in
new furniture as one of their outreach projects.
“It looks like a new home,” she said, smiling.
“You can’t change the plight those kids have gone
through, but you can change the current environment.”
Whether students who work for her program are HIV positive is
not Mabusela’s concern. Rather, she’s interested in
creating a comfortable environment where students can talk about
the virus.
On a good day, she says, up to 40 students can fill up their
lounge area. They are usually students of color.
In a country as racially-divided in South Africa, it is almost
inevitable that fear of the HIV/AIDS would have racist
overtones.
The poor and uneducated are usually the most vulnerable to
HIV/AIDS, and because the vast majority of South Africa’s
poor are black, there is a perception that HIV/AIDS is a black
disease.
Some rumors that circulate about the virus have racist
connotations, for example, that you can get AIDS from kissing a
black person.
In the townships ““ generally poor, rural communities where
primarily black people live ““ AIDS is the worst. In
Ntuli’s township of Clermont, she estimates that among people
between 15 and 25 years old, 60 to 70 percent of them are
HIV-positive.
Mabusela says the myth that AIDS is a black disease largely
stems from media coverage in South Africa. She says when white
people have AIDS, they can afford to go to private clinics that
keep the media out. But poor blacks who have AIDS have to go to
public hospitals where lines can number in the hundreds.
“HIV/AIDS is one of the ways where the socio-economic
conditions of our country and its history show itself,”
Mabusela said. “It’s been painted black because black
people are accessible to the media.”
No one has an answer as to what can be done to stem the tide of
the epidemic. Both Meyer and Mabusela agree that the
country’s HIV/AIDS crisis is getting worse.
The South African government’s response to HIV/AIDS has
been criticized as lackluster, particularly since President Thabo
Mbeki questioned for a time whether HIV does, in fact, cause
AIDS.
Social factors, such as having multiple sexual partners, and
South Africa’s high number of rapes, have spread the virus so
fast that people don’t talk much about stopping it anymore.
Rather, they just continue fighting.
That is what Ntuli will do, and she keeps a photo of her seven
year-old niece on her table as a reminder. “That drives me,
it just makes me want to push harder,” she said.
One year from graduation, Ntuli has high ambitions for a career
in politics, and she hopes of one day returning to Clermont to help
people improve their situation.
“Those who do get out (of the townships) are seriously
blessed,” she said. “And those who do get out have an
obligation to go back and say, “˜I just got out clean. So what
do I need to do now to get my brothers and sisters
out?'”
For decades, South Africa was defined by the fight against
apartheid.
Now, today’s youth may very well be defined by a different
fight ““ the fight against HIV/AIDS.
“It’s our current struggle,” Mabusela said.
“We struggled to get liberation for this country (from
apartheid.) The struggle continues now to fight the
disease.”