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AIDS:
A multifaceted South African crisis (continued)
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The stigma associated with AIDS is so great that HIV positive women live in fear that friends and family members will find out they have the virus. Gray calls AIDS the new apartheid. "Before they were discriminated against because they were black now that are discriminated against because of HIV," Gray says. So women like Moloi suffer in silence. "I haven't told anyone at home. I'm afraid. If you have HIV people will reject you," Moloi says. "They treat you like you've been sleeping around, doing ugly things. I got this virus sitting at home. I didn't expect them to tell me I was HIV positive," Moloi says. Like many of the women who come to Baragwanath, Moloi only found out her HIV status when she became pregnant. Once she told her partner about the baby, he left her. She has not had any contact with him since. Even though Moloi believes she contracted the virus from her child's father and she is aware that he is having a baby with another woman, she will not tell him her HIV status. "I don't know what to do, but I want to stop him," Moloi says, "I really want to help, but I don't know how." Moloi may be able to keep the rumors about her condition at bay while she is pregnant, but once she gives birth, she will have to concoct another set of excuses to explain why she has chosen not to breast feed her baby. Not breast-feeding along with being skinny have become tell-tale signs of HIV status in South Africa's AIDS hysteria. Moloi plans to blame the doctors, saying they told her that her milk is sour. In spite of her dire financial situation, Moloi is adamant, "I don't know how I will get the milk because it's too expensive, but I won't give my baby my breast," Moloi says. With all of these machinations Moloi is not simply trying to protect her reputation, but the fate of her unborn child as well. "When my mother finds out I died of this HIV will she take care of my baby?" Moloi asks. Gray tries to sympathize with the women's predicament. "It's a double edged sword. On the one hand they should tell their partners. But, dear they disclose [their condition] they face being chucked out of their homes and being ostracized," Gray says. But she is still conflicted by their decisions and her role in the process. "It's abhorrent," Gray says, "Sometimes I feel like I am an accomplice to murder because I am not strong enough to get the women to disclose." Similela believes that the same dynamic that makes women unable to reveal their status, also makes it difficult for them to prevent the initial spread of the virus. "Even if I give a woman a condom. Even if I empower her, the power relations are such that she cannot negotiate if she's dependent on this man for money," Similela says. Mpungose agrees with Similela that men are in control when it comes to South Africa's bedrooms. Mpungose says women asking their partners to wear condoms are likely to be met in the sweetest African lilt with these glib replies: "Can you eat a sweet in a plastic? Can you take a shower in a raincoat?" Moloi was a victim of such sweet talk and now she is dependent on her mother who makes fifty rand a month -- less than ten dollars -- for survival. "I don't know where I am going to get money to buy clothes and I only have a month to go," Moloi says. Although her partner will not take responsibility for their child, Moloi fears that she will not be able to get formula at a discounted price because her child's father is employed. Although, Similela recognizes the cultural and economic forces working against HIV positive mothers, she ultimately believes preventing the virus is a matter of choice. "At the end of the day, this disease is about behavior. I can't buy people into changing their behavior. We need people to realize this is a preventable illness, but only if we make the right sort of choices for ourselves," Similela says. But women like Moloi believe the right choice for the government to make would be meet the demand for AZT. So Moloi holds out hope that there will be enough AZT available for her when she reaches her thirty-sixth week of pregnancy and she is quick to criticize the hypocrisy of Minister Zuma's stance. "If you have STD's she give you medicine freely. If you have HIV, she doesn't want to give it to us," Moloi says, "It means she wants our babies to die." And Gray insists that rationing of AZT would end if the Health Ministry would simply allow doctors and hospitals to get their supply of the drug from other sources. Gray has secured a donation from UN AIDS that would supply her staff with enough AZT for the rest of the year, but the Health Ministry will not give permission for her to accept the gift. In response to Gray's charges Similela asks, "Why must donors come to save us from dying? Let them sell the drugs cheaper to us." Similela worries about the government being dependent on donors to provide AZT -- a practice Similela maintains the government would not be able to afford on its own. The Health Ministry has been in a war with drug companies like Glaxo-Wellcome to make AZT less expensive. And while the company has cut its prices, Similela says it is not enough. "They are talking dollars. They are not talking our money," Similela says, pointing out that even with the cut in price, it is still more than South Africa can afford. Gray believes her patients are being put at risk while the Health Ministry tries to strong-arm the drug industry and overlooks the generosity of the non-governmental agencies willing to help pay for the drug. Similela says, "I'm okay with donors coming in saying, What's the best we can do?' without being judgmental -- to be open minded." But, Gray cares little about the government's plight. The health ministry does not "see the cold face of the epidemic," Gray says. |
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