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South Africa

Squatters united in grief

Residents of Lawley squatter camp in peri-urban Johannesburg are helping each other to cope with the devastating effects of HIV/AIDS.
Zachary Ochieng

It is only 8:00 in the morning but the summer heat is already on. As the car meanders through the narrow roads, a somber mood engulfs the air and an aura of deafening silence sets in. For a moment, the place looks deserted. But the tiny tin shacks dotted around the area attests to the presence of human settlement. Welcome to Lawley squatter camp, where death stalks night and day.

This informal settlement 25km south-west of Johannesburg is one of the areas worst hit by HIV/AIDS. With a total of 6000 shacks each housing a family of about five, the HIV prevalence rate by conservative estimate stands at about 30 per cent, one of the highest in the continent. About three people die every week. In some shacks, a number of which are occupied by foreigners, the occupants are too ill to talk, having been confined to bed by all manner of opportunistic infections. With the breadwinners bedridden, a number of families go for days without food. Child-headed households are common phenomena. Other households are headed by ageing grandmothers, left to carry the burden of Aids orphans.

According to Kathy Schaeff, 40, a nurse with the American missionary organization Turn the Tide, South Africa currently has 4 million orphans. The figure is expected to increase to between 7-9 million by 2010. “Even if Aids would be stopped today, the problem of orphans would continue for generations to come”, observes Schaeff. She says that her organization has initiated a youth drop-in-centre, to offer training on the care of Aids orphans when their care givers pass on. “Currently, the orphans are cared for by neighbours and members of the extended family. But these children still get discriminated against”, says Schaeff.

From shack to shack, death beckons. Despite moderate levels of awareness, behaviour change is almost non-existent. The situation is aggravated by repugnant traditional and cultural beliefs. A middle-aged HIV positive man reportedly sodomised his five-year old son in the belief that the act could cure him of Aids.

John Matata [Not his real name], 30, learnt that he was HIV positive in 1998 and deserted the army. “I decided to go for a test following a bout of pneumonia and diarrhea. I was more worried when the woman I had been dating for six months died of Aids-related illness”. He adds: “Since the army does not compensate Aids victims, I decided to leave without revealing my status”. Despite knowing his status, he went ahead and married, without revealing his status to the bride. His wife, who is also HIV positive, learnt of her status last year. Their six-year-old daughter’s status is not known, as child testing is not common in this area. Matata, now on Anti-retroviral Therapy [ART] courtesy of Nazareth House, a Catholic hospice and a clinic, has one advice to those who are HIV-positive: “”, he says confidently: “They must never lose hope”

Matata, who has been on the ART treatment for only six weeks, says his health has improved tremendously and all the symptoms have disappeared. But not all the victims have been lucky. For some, help arrives a few minutes too late. “In one instance early this year, a man died only five minutes after I walked in to see him”, reminisces Cora Bailey, a veterinary surgeon, initially looking after animal health care in the squatter camp.

The severity of the pandemic prompted her to shift her focus to help the sick and dying and find a solution to the teeming population of Aids orphans. “When I came here two years ago, I found a sick lady in her 30s who had three starving babies. I took her to a hospice where her condition improved as the neighbours took care of her children”, says Bailey.

But in the midst of the tragedy, the residents of Lawley have remained united in grief. Besides the orphans being cared for by neighbours, five volunteer homecare providers are cooking for the sick and washing their clothes. A Mozambican, who did not have a family and whose condition had severely deteriorated, was rushed to hospital by neighbours and put on TB treatment. Three months later, his health has since improved. “This shows that the level of stigma within the community has gone down. Initially nobody wanted to be associated with an Aids patient”, observes Fikile Ntumba, a volunteer home-based care provider. Ntumba became a volunteer two years ago after losing her 27-year old daughter to Aids.

A few shacks ahead, Wendy Mkwezo, 30, is running a pre-school crèche that caters for 50 children, 10 of whom are Aids orphans. The two-year old institution, besides providing education, was started with a view to protecting children from rampant abuse. “Our main motive was to keep the children safe”, she asserts. In an area where food is hard to come by, Mkwezo provides the children with two meals a day. The parents who can afford pay her R90 a month for her services, but the orphans are exempted.

But as the pandemic continues to ravage the productive section of the population, the government roll-out plan for the antiretroviral – about the only effective regimen in the management of HIV/AIDS – has been very slow. After the Treatment Action Campaign [TAC] won a court battle two years ago that allowed the importation of cheap generic drugs, president Thabo Mbeki claimed that the antiretrovirals were toxic. Consequently, only 6000 South Africans have access to them, mainly in a few provinces like Gauteng. Save for a few NGOs, free anti-retrovirals can be accessed at Baragwan, the 12000-bed referral hospital located about 30 km south-west of Johannesburg. But for the Lawley residents, a round trip to the hospital costs about R30 [US$5], way beyond the reach of most of them, some of whom were already poor even before Aids set in.
Yet, the gravity of the crisis cannot be underestimated. South Africa, an economic power house on the continent, is home to 5.3 million HIV-infected people - the world's largest. The Aids situation is replicated in other Sub-Saharan African countries. According to UNAIDS’ -- the Joint United Nations Program on HIV/AIDS –“Aids Epidemic Update 2004” - 66 percent of the 38 million people infected with the virus worldwide live in sub-Saharan Africa. An estimated 3.1 million Africans newly contracted HIV in 2004, while 2.3 million died of AIDS.
According to the UNAIDS report, in South Africa, 77 per cent of the young people living with HIV are female. Latest data suggest that the prevalence levels are still increasing in all age groups, except for pregnant women older than 40 years of age. “This is the more reason why we need to redefine 16 days of activism and give more meaning to the whole concept given the vulnerability of women”, says Schaeff.

But as the pandemic continues to decimate the South African population by the million, President Mbeki, like other African leaders has done little to stem the tide. Upon his ascension to power, he packed his cabinet with the so-called “Aids dissidents”, who supported his claim that HIV is not the cause of Aids. Perhaps he should borrow a leaf from Uganda, which is considered a success story in the war against Aids in Africa.

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