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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.
The child in crib No. 17 has had TB, oral thrush, chronic diarrhea, malnutrition, severe vomiting. The vial of blood reveals her real ailment, AIDS, but the disease is not listed on her chart, and her mother says she has no idea why her child is so ill. She breast-fed her for two years, but once the little girl was weaned, she could not keep solid food down. For a long time, her mother thought something was wrong with the food. Now the child is afflicted with so many symptoms that her mother had to bring her to the hospital, from which sick babies rarely return.