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The Dying Game
Monday April 17 2000
Reporter Fergal Keane
Producer David Harrison
Panorama investigates the AIDS crisis in South Africa and asks what can be done about it. With South Africa expecting one million AIDS orphans in the next five years, it is a question everybody involved with the disease is asking.
The scale of the problem defies belief: four million already infected, 1700 more contracting HIV every single day. And these are conservative estimates.
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Panorama travels to an AIDS hostel run by the Salvation Army in one of tougher neighbourhoods of downtown Johannesburg. It is called Ethembeni - the Zulu word for a 'place of hope.' As you walk through the front door, the sound of children's voices echoes along the corridor. The infants - aged between a few months and six years - play in a big room whose walls have been painted with characters from the Lion King. It is bright and cheery and the staff of young black and white women keep a benign eye on the proceedings
"Most of the men they think that sex is a game, like if he meets you today, he says can you be, I love you and I want to spend my life with you. The very same day they go to bed. That's what he wants, so he can be satisfied , and the next day he does and asks someone else again out, says yes, then they sleep with them. They go around sleeping, married, not married, just the same."
Three out of five children at the Ethembeni Hostel are HIV Positive. Most were brought here by the police after being found abandoned on rubbish dumps, in paper bags on city street corners by their HIV positive mothers.
It is happening all the time now, one of the nurses explained: "We just don't have room for the numbers that are coming. We get babies abandoned but also a lot of pregnant mums who come looking for space which we don't have. And we end up asking ourselves 'what can we do'?"
In 1998, the last year for which UN figures are available, there were two million AIDS funerals in sub-Saharan Africa. Every day in countries across the continent they are burying the tens of thousand of people. In countries as far apart as Botswana and Kenya there are villages being depopulated by AIDS. 11.5 million people have already died of AIDS in Africa. The medical term for what is happening is 'pandemic'.
There are also plenty superlatives being bandied around: catastrophe, disaster, holocaust. None of them does justice to the enormity of what is happening. It is perhaps best described as an oncoming age of darkness, a slow falling into the void of an entire African generation.
The West is accustomed to bad news from Africa. Warnings started in the early 90's that AIDS would soon be the biggest story on the continent. But at the time the world's attention was held by the death of apartheid in South Africa and genocide in Rwanda.
But AIDS will kill more people than apartheid or genocide ever did. By the mid 90s it had already devastated Uganda and parts of central Africa, but the more prosperous countries to the South had yet to feel the full impact. Now Zimbabwe confronts the fact that 1 in 5 of it's population is HIV positive. Zambia and Bostwana are already experiencing labour shortages because of their high death rate.
As South Africa's deputy president, Jacob Zuma, said: "Millions of people are going to die. This is like an invading army. The country could take many steps backward. It really is a question of life and death for us."
To illustrate the economic consequences, Panorama visits the gold mines at Carletonville, west of Johannesburg. The mines, which are run by Goldfields PLC , expect to lose forty percent of their workforce in the next ten years, 20,000 skilled workers. Already Goldfields is recruiting more men than it needs in order to make up the shortfall.
Why is this happening? Why should the most developed nation on the continent be ravaged by AIDS in this way? The immediate answer is straightforward: sexual behaviour. The fatal combination of promiscuity with a refusal to practice safe sex is leading millions of South Africans to disaster. This is not a crisis of drug users or homosexuals.
Both of the young women Panorama talked to in the AIDS hostel in Johannesburg caught the virus from men who'd been sleeping around with numerous partners. Neither of the women knew this at the time, believing they were the 'only one.'
In sub-saharan Africa HIV is passed on overwhelmingly through heterosexual sex. It is thought to have arrived in South Africa via truck drivers who'd slept with prostitutes along the north-south trade routes. The mines are particularly badly affected because of the high prevalence of AIDS among the prostitutes who ply their trade around the single sex hostels where the men are quartered.
At the Goldfields Mine in Carletonville around 75 percent of the women are estimated to be HIV positive. They are uniformly poor and most have families to support. In an atmosphere of appalling poverty, a woman who is offered £5 for sex without a condom (it costs £2 with a condom) is often tempted to take the chance.
Why do the men not want to use condoms? On a Saturday night at the Miners Bar in Carletonville you enter an atmosphere drenched in alcohol and sexual hunger. As the music pounds groups of men and women veer back and forth across the floor. Some of the women are prostitutes, others are the 'town' girlfriends of the miners.
Men asked about condoms provided a variety of explanations, the most common being that 'nobody likes to eat a sweet with a wrapping paper on it'. Most of the men said they wanted their sex 'flesh to flesh.' They said they didn't like how condoms felt and sounded. It was not manly.
The miners are carrying the virus back to the rural areas. In one district of the Eastern Cape doctors are reporting that three out of five pregnant women are HIV positive. Some of the men told me they were afraid to produce condoms when they slept with their wives, because they would automatically be accused of infidelity. Others said that many women didn't like condoms because it would prevent them from bearing children.
Magquma faces a daily struggle to feed her family. Should she die from AIDS, the older children will have to become the parents of the younger ones. They will join a generation of orphans in remote villages across South Africa.
One of the more commonly heard refrains is that AIDS was a white man's plot to discourage blacks from having children. The idea melds easily with South Africa's apartheid history.
But Lucky Mazibuko,a member of the country's National Aids Council, believes the time for excuses about behaviour is long over. He is HIV positive and caught the virus through a casual affair. He was living with his partner and children at the time. In Lucky's schooldays they called AIDS 'American Ideas Discouraging Sex.' It was, he says, a 'kind of foolish creativity coming up with a slogan like that.'
Lucky believes in plain speaking, something which is in curiously short supply at government level. There are plenty government statements about AIDS but they are relentlessly bland. According to Lucky Mazibuko the men of South Africa in particular need to hear a direct message telling them to change their ways.
The culture of casual, unprotected sex is quite literally killing South Africa. And no amount of expensive medicine can change human behaviour.
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