Death Stalks A Continent

Sunday, Feb. 04, 2001 By JOHANNA MCGEARY
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Tsepho has been robbed of a childhood that was grim even before his mother fell sick. She supported the family by "buying and selling things," he says, but she never earned more than a pittance. When his middle brother was knocked down by a car and left physically and mentally disabled, Tsepho's mother used the insurance money to build this house, so she would have one thing of value to leave her children. As the walls went up, she fell sick. Tsepho had to nurse her, bathe her, attend to her bodily functions, try to feed her. Her one fear as she lay dying was that her rural relatives would try to steal the house. She wrote a letter bequeathing it to her sons and bade Tsepho hide it.

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As her body lay on the concrete floor awaiting burial, the relatives argued openly about how they would divide up the profits when they sold her dwelling. Tsepho gave the district commissioner's office the letter, preventing his mother's family from grabbing the house. Fine, said his relations; if you think you're a man, you look after your brothers. They have contributed nothing to the boys' welfare since. "It's as if we don't exist anymore either," says Tsepho. Now he struggles to keep house for the others, doing the cooking, cleaning, laundry and shopping.

The boys look at the future with despair. "It is very bleak," says Tsepho, kicking aimlessly at a bare wall. He had to quit school, has no job, will probably never get one. "I've given up my dreams. I have no hope."

Orphans have traditionally been cared for the African way: relatives absorb the children of the dead into their extended families. Some still try, but communities like Tsepho's are becoming saturated with orphans, and families can't afford to take on another kid, leaving thousands alone.

Now many must fend for themselves, struggling to survive. The trauma of losing parents is compounded by the burden of becoming a breadwinner. Most orphans sink into penury, drop out of school, suffer malnutrition, ostracism, psychic distress. Their makeshift households scramble to live on pitiful handouts--from overstretched relatives, a kind neighbor, a state grant--or they beg and steal in the streets. The orphans' present desperation forecloses a brighter future. "They hardly ever succeed in having a life," says Siphelile Kaseke, 22, a counselor at an AIDS orphans' camp near Bulawayo. Without education, girls fall into prostitution, and older boys migrate illegally to South Africa, leaving the younger ones to go on the streets.

Every day spent in this part of Africa is acutely depressing: there is so little countervailing hope to all the stories of the dead and the doomed. "More than anywhere else in the world, AIDS in Africa was met with apathy," says Suzanne LeClerc-Madlala, a lecturer at the University of Natal. The consequences of the silence march on: infection soars, stigma hardens, denial hastens death, and the chasm between knowledge and behavior widens. The present disaster could be dwarfed by the woes that loom if Africa's epidemic rages on. The human losses could wreck the region's frail economies, break down civil societies and incite political instability.

In the face of that, every day good people are doing good things. Like Dr. Moll, who uses his after-job time and his own fund raising to run an extensive volunteer home-care program in KwaZulu-Natal. And Busi Magwazi, who, along with dozens of others, tends the sick for nothing in the Durban-based Sinoziso project. And Patricia Bakwinya, who started her Shining Stars orphan-care program in Francistown with her own zeal and no money, to help youngsters like Tsepho Phale. And countless individuals who give their time and devotion to ease southern Africa's plight.

But these efforts can help only thousands; they cannot turn the tide. The region is caught in a double bind. Without treatment, those with HIV will sicken and die; without prevention, the spread of infection cannot be checked. Southern Africa has no other means available to break the vicious cycle, except to change everyone's sexual behavior--and that isn't happening.

The essential missing ingredient is leadership. Neither the countries of the region nor those of the wealthy world have been able or willing to provide it.

South Africa, comparatively well off, comparatively well educated, has blundered tragically for years. AIDS invaded just when apartheid ended, and a government absorbed in massive transition relegated the disease to a back page. An attempt at a national education campaign wasted millions on a farcical musical. The premature release of a local wonder drug ended in scandal when the drug turned out to be made of industrial solvent. Those fiascoes left the government skittish about embracing expensive programs, inspiring a 1998 decision not to provide azt to HIV-positive pregnant women. Zimbabwe too suffers savagely from feckless leadership. Even in Botswana, where the will to act is gathering strength, the resources to follow through have to come from foreign hands.