World AIDS Day; In Honour of the Community Health Workers

We were nine, ten maybe eleven years old the day that word choked an entire parish into a macabre silence: AIDS! By their very nature churches tend to be solemn places but on that occasion the expressions on the congregants were exceptionally sullen; eyebrows creased, listless stares, uncomfortable shifting in the pews. No doubt this is the reason why we immediately knew that this thing was no laughing matter, because we’d heard of it in church.

The monologue sermons of buttoned-up religion had suddenly evaporated, in their place the more forthright language of biology. Vagina, sexually transmitted diseases, opportunistic infections…

The discomfort was palpable. Hands clasped nervously, eyes cast on the floor, too scared to look the grown-ups in the eye. We’d come up in homes where such candid language was taboo, at school and everywhere else, barring maybe the streets. These, however, were desperate times. 

People were taking ill fast. Coughing up blood, diarrhea for days, withering away before keeling over and dying. It was clear; there was no recovering from this. If you had it, best arrange for a priest because you were fated to an early appointment with thine maker. Paranoia and fear leered eerily everywhere. And whenever fear abounds, misinformation, myth and utter human stupidity are always just there waiting to happen.

In no time the speculative theories became gospel. You had the disease because you were a promiscuous woman of questionable morals or an abominable man who had relations with other men. Adulturous women and homosexuals. This was the God-ordained punishment for erring off the straight and narrow. 

Surrounded by stigma, many sufferers died alone. Shunned by family, friends no longer taking their calls, they would go lonely and dejected into the night. It didn’t help that these were the transitional years, the ANC government inheriting a bankrupt fiscus; majority of the population living in squalor and with little access to housing, electricity and other basic services.

Against this backdrop, the first democratically-elected president, Nelson Mandela, was faced with the monumental task of addressing the iniquities. Sadly, this came at the expense of not saying much about this disease that was like a plague, decimating scores, leaving corpses in its wake. It would not be until after retirement where through his 46664 campaign, that Madiba would come out in earnest against the scourge. 

But for the millions suffering from the disease stood a more tragic obstacle to their plight. Madiba’s successor, Thabo Mbeki’s AIDS denialism still continues to cast a dark shadow over the man’s legacy. Not only was the former statesman questioning established scientific fact but confounding utterances were glibly falling from the mouth of his health minister, the most infamous being; “Shall I repeat garlic, shall I talk about betroot, shall I talk about lemon… these delay the development of HIV to AIDS-defining conditions, and that’s the truth.” 

Eish! 

It would not be until the now frowned-upon Jacob Zuma rose to the highest office in the land that the nation would see a massive rollout of critical Anti-Retroviral Therapy (ART).

Today, however, eParkeni’s beat, a few days after World AIDS Day commemorated on 1 December, winds us down a dirt thoroughfare into a self-effacing face-brick building with a manicured lawn, brimming corridors and Khayakazi Vyfer asking, “how may I help you?”

Nicknamed Maddona owing to her easy smile and bubbly personality, she is a receptionist at the Kuyasa Clinic and the first port of call to the hundred-odd people who are queueing as early as 7am outside the facility’s gates. She turns out to be one of those disarming sorts with a cordial temperament, a master archivist who sometimes knows exactly where whose medical file went off by heart.

An aside: she once breezily retrieved the writer’s file despite him not having been to the clinic in over a decade and had forgotten his file number.

Today, as on all other days, a horde gathers on the porch outside, pile the chairs in the designated waiting areas listening for their names to be called. The nursing staff, three obviously inundated busybodies slip between the consultation rooms and dispensary bent on shortening the waiting list in the quickest possible time. A well-oiled circus but amid the attractions we are here for the spectacle of a few ladies who are at the coalface in the fight against HIV/AIDS.

Their working title is Community Health Workers. But the more accurate term would probably be along the lines of The Tireless Weather-beaten Crusaders. Amongst their myriad responsibilities is to establish close ties with those in the community battling with HIV/AIDS. As non office-bound fieldworkers, they have grown a tough skin, daily contending with the elements. Rain or shine, they’ve learnt to steel themselves, tough it out without the luxuries of an office or vehicle whilst keeping the spirits of their clients upbeat. An all-in-one package, they provide counselling, treatment and are a compassionate shoulder to cry on for those who may not have such crucial support structures. 

Furthermore, one was won over by their cunning proactivity. If one conflates the country’s roughly  “1 in about 7” HIV/AIDS statistic, this potentially works out to at least 3370 of Colesberg’s population of 16 869 (according to the 2011 census) who are living with the virus. As would be expected, this means a clustered public health care experience with winding queues and an overburdened staff. Our Crusaders had just the solution: dispense ART treatment at those public facilities nearest to the areas where these people live. The Mongezi Juda Library, Love Life Youth Centre, amongst others, have been reliable partners in this respect.

Largely it is through individuals such as the Crusaders that the message of “acceptance” is reverberating far and wide. The days where being HIV+ was something to hide, to be ashamed of, are slowly becoming something of the dark ages. You don’t believe me? Well, why else is it that the writer got to mingle with a few gentlemen who’d come to collect their ART medication nonchalantly referring to the pills as “amandomgomane” – peanuts – to their collective chuckling? Or why few bat an eyelid at serodiscordant (where one partner has HIV and the other doesn’t) couples? 

ART has taken the poison out of the virus’s bite. Not only has it contributed to the national increase in life expectancy but has also removed the perception of HIV/AIDS being a death sentence. With effective compliance to one’s treatment regimen, one can reach and maintain an “undetectable” viral load, meaning although the virus remains active in the individual, they are unable to sexually-transmit it to another. U=U or Undetectable=U transmittable is a phrase that has the Crusaders particularly pleased for their patients.

With a few more questions left to ask, sadly the Crusaders had to cut the interview short. Duty called. A few took the time to pose for a picture, the rest were either camera shy or eager to hit the ground running. What had been a bustling consultation room soon fell empty. The Crusaders were off to save human lives. Imagine if we had these people 28 years ago. Now wouldn’t that have been something special.