AIDS messages leave San community behind

Sofia is propped against the wall of her two-roomed home, wrapped in a blanket, trying to warm herself in the weak, winter sun. Many of her neighbours in this recently built township, about 15km outside Kimberley, in South Africa's Northern Cape Province are doing the same.

Their identical, cinder-block homes, built by the government just three years ago, mostly lack furniture. When the sun goes down families build fires on the floors of their living areas.

Sofia [not her real name] greets Flumena Manzono, a home-based care-giver with the local Red Cross Society, in !Xun, an indigenous San language and the only language she knows.

The 24-year-old was born in Namibia, where her father, along with many other !Xun men, was recruited by the former South African Defence Force (SADF) as a tracker. When the war ended and the !Xun found themselves on the losing side, they accepted the SADF's offer to relocate to a military base in Northern Cape, along with another San community called the Khwe, who had fought for the SADF in Angola.

About 6,000 !Xun and Khwe were housed in tents on the remote, windswept plain of Schmidtsdrift, about 90km from Kimberley. They remained there for 12 years while South Africa's new democratic government decided what to do with them. Finally, each family was awarded a resettlement grant which they pooled to buy the three farms that now make up the township of Platfontein.

By the time of the move to Platfontein, Sofia's parents had both died and Sofia had dropped out of school and had a child. By that time, she had probably also contracted HIV.

“I didn’t know about condoms,” she said, speaking through a translator. The little she knew about HIV she learned from the local San-language radio station. “The pamphlets and information aren’t in my language, even now.”

When Sofia first started feeling unwell in November 2005, the nurse at Platfontein’s tiny health clinic, which still lacks indoor toilets and running water, gave her pain killers. Eventually she became so sick that her cousin called an ambulance to take her to the hospital in Kimberley where she was diagnosed HIV positive.

It's a long journey by foot to the hospital and the township still lacks public transport, but Sofia returned there recently to try to access antiretroviral treatment. She was turned away because, like most people in Platfontein, she lacks an identification book. The Red Cross is helping her to get one and in the meantime Manzono checks on her daily.

Besides Manzono, nobody else knows Sofia is HIV positive. She has not confided in her aunt, whom she lives with, or anyone else in her family and she chased away her boyfriend when she discovered her status.

“The stigma is worse here than other places,” said Gail Moorkroof, who coordinates Platfontein’s five Red Cross care-givers, all of them recruited locally. “No one is open about their status.”

A decade behind

The adult HIV prevalence for the province is estimated at 18.5 percent, but no one knows how many people in Platfontein are living with the virus. In three years, Leela Alexander, the sister in charge at Platfontein’s clinic, has tested just 10 people for HIV. She suspects that most people prefer to test in Kimberley where there is less chance of running into someone they know.

In terms of their awareness and attitudes towards HIV and AIDS, the San people of Platfontein are probably a decade behind most of the rest of the country. Geographically, culturally and linguistically isolated for so many years, they are still struggling to come to terms with the disease.

“When this illness came into the world, San people were not aware of it,” Nepa Kadombera, vice-chair of the !Xun Community Development Council told IRIN/PlusNews.

Photo: Kristy Siegfried/PlusNews

San women from Platfontein regularly walk to the local rubbish dump to search for food and clothing for their families

“San people never knew of condoms,” added Benedicto Kavanda, another member of the council. “They stayed in the Veld [bush] and if the illness had been there then, all of them would have died because our numbers are few.”

Zeka Shiwarra, a Khwe leader, dates the community’s exposure to HIV to the time they moved to Schmidtsdrift.

“Our people started mixing with people from outside the camp and we started seeing more and more STIs (sexually transmitted infections),” he recalled. “There was also a lot of deployment of soldiers from our community to other parts of the country during the 1990s. We started noticing it [HIV] in our community around 2000.”

The move to Platfontein, in 2004, brought greater access to health services and information about HIV and AIDS, but some believe it also increased the community’s vulnerability to the virus.

“Previously, there was a problem with teen pregnancies, but not like now. Young people are getting involved with other communities and drinking at taverns,” said Mario Mahongo, the !Xun’s traditional leader.

Cultural relevance

According to Meryl-Joy Schippers, director of the South African San Institute (SASI), years of dislocation and isolation have only increased the community’s desire to cling to their traditional values and language. Older people in particular tend to view HIV as a symptom of the gradual erosion of those values and one more reason to mistrust outsiders. At the same time, they have been forced to accept the need for outside help to treat and prevent the spread of the virus in their community.

“Our ancestors don’t recognise this illness so they can’t advise us,” said Shiwarra. “Our traditional healers would rather refer people to western doctors.”

Ill-equipped and uncomfortable with talking to young people about sexual issues, traditional leaders have allowed organisations like the Red Cross, SASI and LoveLife, a national HIV prevention programme targeted at the youth, to do the talking for them.

LoveLife has recruited two young local women, one !Xun and one Khwe, as “groundbreakers” – peer educators who talk to young people at the local school and clinic and through the community radio station about HIV and related issues such as teenage pregnancy and alcohol abuse.

The stigma is worse here than other places.

“Alcohol abuse is the biggest problem,” said Noria Mbangu, the Khwe groundbreaker. “They start as young as 12 and they buy it from the tavern on the Khwe side; there’s no other place for young people to go.”

According to Chris Mpisi, SASI’s coordinator for Platfontein, well-meaning government and non-government projects have had mixed results trying to reach the community with HIV prevention messages.

“They don’t always think through the language challenges and the context,” he said. “The culture they’re coming from, you don’t just hand out packets of condoms. It’s not an openly discussed thing in Platfontein, but they’re saying it needs to be communicated to us in a way we understand.”

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