The most remarkable thing about Three Letter Plague, the book about Lusikisiki and the AIDS epidemic in the Transkei written by Jonny Steinberg, is not the politics around President Mbeki and his ongoing denial of AIDS. It’s not the struggle amid the shortages of almost everything needed in a health care system but rather the impact made by individuals who find ways and means to bypass obstacles in the health care system to make sure that people get care when they need it..
Pharmacy workers that get medicines through where it was thought impossible, lay persons that counsel and guide patients in the regular taking of their antiretrovirals and members of the rural communities that have tested and been found HIV positive who are living and counselling others despite a massive stigma and sometimes being ostracised from their communities.
Jonny Steinberg has captured a vivid picture of the Transkei and its hardships and desperate daily struggle just to survive. Add in AIDS and a government not willing to effectively rollout the medication that will save lives and there is a recipe for disaster and needless death.
The human spirit however is a curious phenomenon and this combustible situation has brought out some extremes in people with some taking their HIV positive test as a signal to help others and band together in groups thereby gaining strength in numbers.
The characters who have gone above and beyond the call of duty, in assisting to get people to clinics, making sure medicines arrive at the clinic and following up continuously with others who need to keep taking their antiretrovirals, are ordinary people living in extraordinary times.
They are real pioneers and ready to experiment when traditional methods used by the sangomas do not make an impact on the problem. There is a remarkable amount of rumour and unproven stories bandied about in the rural areas regarding the origins of AIDS, the idea that it only seems to affect black people as well as the shunning of those tested positive in case something should rub off when in contact with them.
In his book Steinberg has highlighted people born and raised in the rural villages, steeped in tribal traditions and ancient customs who have seen what this epidemic can do and also what antiretrovirals are capable of, namely saving lives and making HIV positive people able to function and contribute positively in society.
A paradigm shift is going to be needed if South Africa is going to weather this storm, not only the deaths but those that are left behind, especially the orphans.
The idea that the virus should be seen as a chronic illness rather than a death sentence is a step forward but its going to take some leadership in going forward and burying the uncertainty created by leaders that have encouraged a belief in better eating habits as a cure rather than a support system for antiretrovirals.
Rolling out antiretrovirals is only a start, maintaining the logistics and backup so that medicine is available when it is needed in order to sustain a life saving and life enhancing program will take strategic planning and sustained implementation.
Here’s a great link to some answers Steinberg had to questions about AIDS and South Africa.
http://www.news24.com/News24/South_Africa/News/0,,2-7-1442_2321323,00.html
Another interesting link
Yet another interesting link
http://www.pbs.org/kcet/tavissmiley/archive/200802/20080226_steinberg.html
