Death Stalks A Continent

Sunday, Feb. 04, 2001 By JOHANNA MCGEARY
Article Tools
Print
Reprints
Sphere
RSS

(6 of 9)
Rare is the man who even knows his HIV status: males widely refuse testing even when they fall ill. And many men who suspect they are HIV positive embrace a flawed logic: if I'm already infected, I can sleep around because I can't get it again. But women are the ones who progress to full-blown AIDS first and die fastest, and the underlying cause is not just sex but power. Wives and girlfriends and even prostitutes in this part of the world can't easily say no to sex on a man's terms. It matters little what comes into play, whether it is culture or tradition or the pathology of violence or issues of male identity or the subservient status of women.

Related Articles

Beneath a translucent scalp, the plates of Gertrude Dhlamini's cranium etch a geography of pain. Her illness is obvious in the thin, stretched skin under which veins throb with the shingles that have blinded her left eye and scarred that side of her face. At 39, she looks 70. The agonizing thrush, a kind of fungus, that paralyzed her throat has ebbed enough to enable her to swallow a spoon or two of warm gruel, but most of the nourishment flows away in constant diarrhea. She struggles to keep her hand from scratching restlessly at the scaly rash flushing her other cheek. She is not ashamed to proclaim her illness to the world. "It must be told," she says.

Gertrude is thrice rejected. At 19 she bore a son to a boyfriend who soon left her, taking away the child. A second boyfriend got her pregnant in 1994 but disappeared in anger when their daughter was born sickly with HIV. A doctor told Gertrude it was her fault, so she blamed herself that little Noluthando was never well in the two years she survived. Gertrude never told the doctor the baby's father had slept with other women. "I was afraid to," she says, "though I sincerely believe he gave the sickness to me." Now, she says, "I have rent him from my heart. And I will never have another man in my life."

Gertrude begged her relatives to take her in, but when she revealed the name of her illness, they berated her. They made her the household drudge, telling her never to touch their food or their cooking pots. They gave her a bowl and a spoon strictly for her own use. After a few months, they threw her out.

Gertrude sits upright on a donated bed in a cardboard shack in a rough Durban township that is now the compass of her world. Perhaps 10 ft. square, the little windowless room contains a bed, one sheet and blanket, a change of clothes and a tiny cooking ring, but she has no money for paraffin to heat the food that a home-care worker brings. She must fetch water and use a toilet down the hill. "Everything I have," she says, "is a gift." Now the school that owns the land under her hut wants to turn it into a playground and she worries about where she will go. Gertrude rubs and rubs at her raw cheek. "I pray and pray to God," she says, "not to take my soul while I am alone in this room."

Women like Gertrude were brought up to be subservient to men. Especially in matters of sex, the man is always in charge. Women feel powerless to change sexual behavior. Even when a woman wants to protect herself, she usually can't: it is not uncommon for men to beat partners who refuse intercourse or request a condom. "Real men" don't use them, so women who want their partners to must fight deeply ingrained taboos. Talk to him about donning a rubber sheath and be prepared for accusations, abuse or abandonment.

A nurse in Durban, coming home from an AIDS training class, suggested that her mate should put on a condom, as a kind of homework exercise. He grabbed a pot and banged loudly on it with a knife, calling all the neighbors into his house. He pointed the knife at his wife and demanded: "Where was she between 4 p.m. and now? Why is she suddenly suggesting this? What has changed after 20 years that she wants a condom?"

Schoolteacher Syabusi is an educated man, fully cognizant of the AIDS threat. Yet even he bristles when asked if he uses a condom. "Humph," he says with a fine snort. "That question is nonnegotiable." So despite extensive distribution of free condoms, they often go unused. Astonishing myths have sprung up. If you don one, your erection can't grow. Free condoms must be too cheap to be safe: they have been stored too long, kept too hot, kept too cold. Condoms fill up with germs, so they spread AIDS. Condoms from overseas bring the disease with them. Foreign governments that donate condoms put holes in them so that Africans will die. Education programs find it hard to compete with the power of the grapevine.

The Child in No. 17
In crib No. 17 of the spartan but crowded children's ward at the Church of Scotland Hospital in KwaZulu-Natal, a tiny, staring child lies dying. She is three and has hardly known a day of good health. Now her skin wrinkles around her body like an oversize suit, and her twig-size bones can barely hold her vertical as nurses search for a vein to take blood. In the frail arms hooked up to transfusion tubes, her veins have collapsed. The nurses palpate a threadlike vessel on the child's forehead. She mews like a wounded animal as one tightens a rubber band around her head to raise the vein. Tears pour unnoticed from her mother's eyes as she watches the needle tap-tap at her daughter's temple. Each time the whimpering child lifts a wan hand to brush away the pain, her mother gently lowers it. Drop by drop, the nurses manage to collect 1 cc of blood in five minutes.