CHAPTER 3 CHAPTER 3
3.5 AIDS - the new crisis
The enormity of the crisis is beyond human comprehension. But perhaps what is even more unimaginable but real is the additional horror that the AIDS crisis has brought into the lives of women and girl children. Studies conducted in 1995 by the University of Natal’s Medical school at Durban’s largest provincial hospitals indicated a 20,13% HIV positive rate amongst pregnant women (Leclerc-Madlala 1997:366). This figure is continually rising with some suggesting that the prevalence of HIV in antenatal clinics throughout the province rose from 9.6% in 1993 to as much as 18.23% in 1995 (Whiteside 1996:18). “KwaZulu-Natal is the province hardest hit by the epidemic. Anonymous population-based surveys conducted in KZN have demonstrated that HIV is about four times more common among young women compared to men...” (Abdool Karim 1998:17).
It is now a well attested fact that there are several biological factors that enhance the
transmission of HIV in women (see Abdool Karim 1998). This biological disposition coupled with the disadvantaged and oppressive socio-cultural situation of women means the odds are stacked against them. Given the shockingly high incidence of domestic violence and rape that is now being profiled even in the popular media, the magnitude of women’s vulnerability to the disease is overwhelming. Some gender activists are arguing that the increase in violence against women has a direct relationship to the growing prevalence of AIDS (Pendry 1998).
Even more alarming from an ethical as well as socio-economic view is the fact that infection seems to be more common among young women between the ages of 15 and 25. “During recent workshops with teachers in Pietermaritzburg, the general consensus was that young girls, particularly in urban townships, are becoming sexually active by the age of thirteen or fourteen. Often this is coupled with less ability to make informed decisions, and the inability to negotiate safer sex, placing them at high risk of contracting HIV” (Whiteside et al
1995:26). With these indications that the disease is spreading most rapidly among young people, researcher Suzanne Leclerc-Madlala (1997) interviewed 100 Zulu-speaking youth from the townships around Durban between the ages of 18 and 25 years. Responses seemed to indicate a disturbing trend suggesting that young people were deliberately spreading AIDS .
Contracting the HIV/AIDS virus was seen more or less as a new part of growing up...accepted...as an almost inevitable consequence of being an adult
...The general feeling was that it was just a matter of time if they were not already infected and they were quite confident that many, if not most of their peers had already contracted the virus...However, it is the rare individual who actually wants to have his/her HIV status confirmed (Leclerc-Madlala
1997:367-368).
These young people seemed to suggest that knowing you were HIV positive was not only a death sentence, but also a passport for sexual licence. Spreading the disease appeared to be the most common way of coping.
The boys are spreading this, so we must spread it back to them. You see them at parties picking up as many girls as they can. Why? They don’t want to die alone. Neither do we (Leclerc-Madlala 1997:369).
For young women, the fear that men would respond to a positive diagnosis by raping women was cited as the major reason why medical authorities should desist in disclosing one’s HIV status (Leclerc-Madlala 1997:372). This fear seems justified as the young men made several references to brutality in their accounts of sexual relationships (Leclerc-Madlala 1997:373).
As Campbell (1992) has indicated, young men engage in forced sex as a way of gaining dominance and control over women. Leclerc-Madlala (1997:373) suggests that this view is consistent with her research findings which also show a proliferation of gangs in urban townships since 1994. These gangs of young men are involved in various forms of criminal activity including rape (Leclerc-Madlala 1997:373).
In KwaMashu, Durban’s second largest township, a gang called Bhepa Span (bepha is derived from a Zulu word for crude sex) walk the streets in the evening looking for girls to rape (Leclerc-Madlala 1997:373)
According to her informants, gang rape, where girls are often abducted at gunpoint has become a commonplace feature of township life (Leclerc-Madlala 1997:373). Estimates of rape country wide show a dramatic increase over the past six years. Leclerc-Madlala (1997) reports that her requests to view police statistics for June 1996 were repeatedly turned down,
with one police spokesperson claiming that if the public knew the actual seriousness of the crisis, there would be “moral panic” (Leclerc-Madlala 1997:374).
Perhaps a little “moral panic” would be appropriate! Rape it seems is not confined to women (young and old), but extends to the rape of very young girl-children. Stories surfacing in recent times warrant not simply “moral panic” but “moral outrage”. Leclerc-Madlala’s (1997) study also indicated that child rape was seen as a preventive measure against
contracting AIDS. “Your chances of not getting it [AIDS] are better if you go for 6 or 8 year olds. Not 10 year olds, some are already pretty experienced by that time already” (Leclerc- Madlala 1997:375). This same research showed that virologists at the University of Natal’s Medical School have reported a steady increase in the past few years of the number of HIV positive African female children between the ages of five and fourteen.
The only likely explanation from their point of view was that men with AIDS were raping or having sex with virgin girls, as the girls who were infected through their mothers had usually died before this time, and the ones who picked up the infection while sexually active were usually older (Leclerc- Madlala 1997:375)
Thus it appears that not only is girl-child rape used as a preventative measure, but a myth has emerged within communities that sex with a young girl-child will cure the disease.
Horrendous stories confirming this view are slowly being documented (Natal Witness 31 July 1999) and are not only confined to urban areas.11
Communities clearly feel desperate about the alarming effects of the AIDS pandemic on the lives of their young people (even when the disease and the magnitude of its effects is not openly acknowledged). It has been suggested that a major reason for the breakdown in sex education between the young and the old is the fact that initiation schools with appointed sex educators no longer function in Zulu society. Parents were never expected to fulfill the role of sex educator. With the demise of these initiation schools, parents are now obliged to fulfill
11 Statistics show that child rape in rural areas is on the increase (e-PRAXIS Inter-Religious E-mail Conference, 30 July 1999, [email protected]).
a role that culturally and educationally they are ill-equipped to handle.12 One response in terms of trying to educate their children around sex issues has been to reintroduce virginity testing among young girls. During a discussion with women in Nxamalala, the issue surfaced in November 1998 shortly after there had been media coverage of the revival of “this age-old tradition”:
12 This was first drawn to my attention in November 1996 in discussion with a group of women in Sweetwaters which included the few professional women from the congregation. It has since been confirmed by a colleague Thulani Ngcobo who works in Edendale, during a clergy gathering in August 1999 where theological reflections on AIDS were discussed.
BH: Who suggested that the virginity test should happen, who said that it should start again here?
TM: Kwakunabafikile nje bakwa ANC babelapha eMaritzburg.
There were ANC members here in Maritzburg
BH: But was it men or women?
TM: Abantu besifazane
Women
BH: Why do they think it's a good idea?
TM: Babethi zitshelwe nje izingane ukuthi kufanele ziziphathe kanjani zitshelwe nangeAids. Okusempeleni nje kwakuyiloko ukuthi ngoba kunesifo esikhona iAIDS izingane kufanele zifundiswe ukuthi kufanele ziziphathe kanjani kungcono zihlolwe kuzanywe ukupreventa iAIDS
They said children must be taught how to behave and should be
taught about AIDS. Briefly they were talking about the fact that since there is this sickness called AIDS children must be taught how to behave themselves; they should undergo a virginity test in order to prevent AIDS...
The extent to which this movement is truly led by women rather than by the male leadership of rural communities is not clear. Women themselves seem ambivalent about the practice for themselves, but particularly for their daughters. At a workshop held in Pietermaritzburg in June 1999 on the issue of virginity testing, organised by the Midlands Women’s Group and attended by a cross-section of women from rural and urban communities, a decision was taken against virginity testing (Witness Echo 17 June 1999). However, this was not a view held by all participants. During an informal conversation I met one young woman who was a
university trained teacher living and working in the rural Midlands who believed strongly that virginity testing was important because the practice enabled Zulu women to regain a sense of value and love for their culture which, for her, mitigated it being used as a tool of oppression.
She herself actively advocated virginity testing in her community. Generally it seems that gender activists such as Phumele Ntombela-Nzimande, deputy chairperson of the Commission for Gender Equality, are critical of the practice and view it as a form of abuse against young women (Witness Echo 26 August 1999).
The attitudes of Nxamalala women in the Bible study group to virginity testing seemed to shift over time and with more factual information being brought to our discussions through two members who attended the workshop referred to above. Mrs Mdluli who had suggested that virginity testing should occur when the issue was first raised in November 1998, was one of the women who attended the workshop in June 1999. As a result her opinion on the matter showed a far more critical attitude and included questioning the advocacy role of men in the practice (Thandiwe Mdluli, 17 June 1999, Nxamalala):
Ngoba kushuthi thina bantu besifazane? Yini njalo sihlale sigcinezelwe kwenzeke izinto ezingasile kithina abafana abagadwa ngani, abahlolwa ngani abafana? Yini kungake kuthiwe, “namhlanje uyashada biza omama uKhoza simhlole uGrace” nomfana naye kuthiwe asihambe somthatha naye ukuze
sibone ukuthi akanalutho. Umfana yena akazukwenziwa lutho kodwa konke kuzokwenziwa yithina.
Why are we always oppressed as women? Bad things always happen to us and why can’t the boys get their virginity tested and be guided? Why can’t we say,
‘today Grace is getting married, let us call mama Khoza,” so that we will test her virginity and go and take the boy so that we will see if he doesn’t have anything. There is nothing that will be done to the boy but everything will be done to us.
By the end of this discussion, many of the group members were expressing ambivalence about having their daughters tested because it was perceived to be a process in the control of men in the community. The women also began to recognise that, as mothers, they need to find ways of talking to their daughters about sexuality issues, even though they find this difficult.
However, whatever women feel about the cultural practice of virginity testing, as a measure taken to prevent AIDS spreading amongst young people, it appears to be having a disturbing reverse effect. According to Dr Neil McKerrow, a paediatrician at Grey’s Hospital,
Pietermaritzburg, “a serious cause for concern is that young women are resorting to anal sex as they... still pass their virginity test but it [anal sex] increases their risk of contracting HIV/AIDS” (Witness Echo 17 June 1999).
Educating young people about the spread of the disease is clearly of paramount importance, so is providing a sense of hope and meaning in terms of economic opportunities for the future and all these issues need to be tackled simultaneously. While attempts to do this are slowly being made, perhaps most significantly by young people themselves (see Agenda (39) 1998:82-86), the reality of the impact of the AIDS pandemic on these young lives is surfacing. It is the girl-children who are carrying the additional burden brought on by the disease. Because so many women are dying, female children being forced through
circumstance to care for siblings in the family. In certain rural areas such as Izingolweni near Port Shepstone on the South Coast of KwaZulu-Natal, reports are filtering through of almost entire villages of orphans (Sunday Times 6 September 1998).
Precious Gambushe is just 13, but she cooks, cleans and cares for her 14 orphaned sisters and cousins. She has not become their guardian by choice:
AIDS has killed her parents and aunt... At the nearby Murchison Hospital half the patients whose blood is tested are HIV positive... Precious’s mother, Ntomfuthi Gambushe, and her father Agrippa Mkhize, went to Durban to work more than four years ago, leaving their five daughters in the care of
Ntomfuthi’s mother, Mercy Gambushe. Ntomfuthi returned home in May this year, rail thin and weary. Her common law husband, Mkhize, was already dead. “When my mother came home she was very sick,” says Precious. “But she was only sick for one month before she died.” Ntomfuthi’s sister, Mildred, also returned home from Durban two years ago, her body ravaged by AIDS.
Mildred died last February leaving behind six children. Precious says she does not know whether her other aunt, Sibongile, is dead or alive. Sibongile, whose four children are also in Precious’s care, went to Durban nearly three years ago and the family have not seen or heard from her since. “She might have died already or maybe she will come home sick like my aunt and mother did,” says Precious. The children’s grandmother, Mercy Gambushe, who is crippled with arthritis, uses her pension of R490 a month to pay for school fees and food for herself and the 15 grandchildren. Despite her hard life, Precious takes her education seriously. “I would like to be a nurse one day so I can help people who are sick,” she says tearfully (Sunday Times 6 September 1998).
The assumption that AIDS deaths will generate an increasing number of child-headed
households is refuted in a recent study conducted in seven peri-urban and urban communities in and around Pietermaritzburg (Marcus 1999). Marcus argues that while they exist, they are the exception. Instead, it is particularly grandmothers who are bearing the brunt of the disease. Of course what Precious Gambushe’s story highlights is the fact that the aged, while providing the financial means, are often not in a position to physically fulfill the care-giving role, leaving this task to the eldest girl-child in her care. This provides a sober warning of the magnitude of distress that will be placed on children in areas such as Edendale which adjoins Vulindlela, given the prediction figures of AIDS-orphans quoted above. From personal
experience within the Anglican Church in Sweetwaters, households of women ranging in age from five to seventy-five, all of whom are “sick”, and where a number of family members of have died, is not unfamiliar.
What Marcus’s study does confirm is the profound social and economic consequences that multiple adult deaths have for households in the Pietermaritzburg area, which are already a common occurrence. Young adult deaths “remove income earners and they increase pressures on already overburdened caregivers, many of whom are grandmothers” (Marcus 1999:47). As mentioned earlier, old-age pensions become the crucial source of income for these families.
The findings of the study highlight the disproportionately negative
consequences of HIV/AIDS and other chronic illnesses for women in poor communities around Pietermaritzburg. For the most part it is the women who nurse the chronically ill and dying and who struggle to meet the costs of treatment. Invariably it is they who are left with the children of the deceased, adding to domestic and economic responsibilities that for many are already onerous (Marcus 1999:48).
In my work with women of Sweetwaters and Nxamalala, the dilemma I have had to face has been the question of how to provide opportunities to discuss openly the burden they carry (and will do so increasingly) as a result the AIDS crisis, given the immense secrecy surrounding AIDS and the stigma attached to the disease. As Marcus points out,
[p]eople generally do not refer to it by name, often talking about “this thing”
(intoyakhe), and there is a string of euphemisms commonly used to refer to AIDS... Alternatively, people are said often to refer to AIDS by naming it as a more acceptable illness such as TB, chest pains - or as bewitchment... “Yes, there is amagobhongo umeqo (like being bewitched through evil spirits) and others have referred to it as pneumonia. You hear some people say that he has died of pneumonia whereas it was AIDS” (1999:9).
Getting women to openly acknowledge that AIDS exists, let alone that it is the “sickness” that is killing their young people, is a long process. In Nxamalala, the first opportunity to discuss AIDS opened up unexpectedly during a Bible study discussion in February 1998 on the text Mark 5:21-43. This text includes a story of a woman who has been haemorrhaging for twelve years and touches Jesus’s garment in order to be healed. I asked the question as to how the story “could be the same for us women today”? Mrs Ncgongo responded, “Ingculazi”
[AIDS]. I then asked her to explain a little more what she meant. She replied, “Ingculazi siyiqhathanisa nayo ngoba phela angithi lesisifo asilapheki manjena kusho ukuthi odokotela bayehluleka wukusilapha sikudla nje njalo uze ufe” [AIDS is comparable to this because it is incurable that means that the doctors fail to cure it, it eats you till you die]. When I pushed the issue further, Mrs Shabangu continued, “Wukuthi ngesikhathi sanamhlanjena uma
uvelelwa wukopha kuye kuthiwe usunengculazi ngoba nokopha bekungelapheki umuntu ubeze ahambe emhlabeni kungelapheki” [Its just that in these days if you happen to be bleeding it is assumed that you have AIDS because the haemorrhage also was incurable, a person would die without it being cured].
From these beginnings, the discussion continued as to how the woman with the haemorrhage might be like a woman with AIDS. It was acknowledged that in both instances “bad” blood ran through the veins of the women, suggesting the deeply personal and intimate nature of their illnesses. The Nxamalala women implied that because this was so, they had no-one but God to turn to. This declaration led to the suggestion that in situations of “blood diseases”, it is the “power of God” that also runs in their veins which enables them to have life in the face of these diseases that bring death.
I then asked them to divide into two groups and draw what we had been talking about in an attempt to access more hidden aspects of how they viewed the relationship between the
“bleeding woman” and AIDS. From this exercise the women admitted that they knew little about the disease, with the unanimous exception that those who had it, had been given the illness by a man! Towards the end of the discussion I offered the example of an AIDS awareness church service that had been organised in St Raphael’s Sweetwaters a few months before to suggest that perhaps we could learn more about AIDS. It was agreed that we discuss AIDS further the following week.