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SOUTH AFRICA: Mixed response to AIDS door-to-door campaign

[This report does not necessarily reflect the views of the United Nations]

JOHANNESBURG, 1 December (PLUSNEWS) - The Alexandra Community Centre in Johannesburg was buzzing with activity, as a group of young people milled around the parking lot, dressed in white T-shirts with bold AIDS logos and bags slung across their shoulders.

It was Friday - the fifth day of the Gauteng Province's door-to-door anti-AIDS campaign, and only two more days were left before it was wrapped up on World AIDS Day.

The campaign has been conducted to raise awareness, "strengthen support for HIV-positive people and also focuses on the needs of orphans and vulnerable children", a provincial statement said. Last year 10,000 volunteers visited homes and provided information and education to 4.6 million people throughout the province, the country's economic heartland.

Zechariah Ndlovu, a young man dressed in the regulation white T-shirt and black jeans, was at the centre "first thing this morning". He and seven others were waiting for their group leader to lead them to Ward 75 - an infamous part of Alexandra township, populated mainly by male hostel dwellers.

Alexandra (Alex), is one of South Africa's oldest townships, located in close proximity to the posh northern suburbs of Johannesburg.

After seeing a good friend die of AIDS-related causes last year, Ndlovu decided to join the campaign and teach others about the disease. "I see myself as a foot soldier in this war against this deadly disease. I was also unemployed, so I decided to do something that would keep me busy," he told PlusNews.

The biggest problems in Alex, according to Ndlovu, are poverty and HIV/AIDS. These are issues that members of the 'Friends for Life' NGO grapple with daily - not just on World AIDS Day.

Friends for Life provides voluntary counselling and testing (VCT) services, home-based and orphan care; runs education and awareness projects, and a support group for HIV-positive Alex residents.

Partnerships with the AIDS lobby group, Treatment Action Campaign, and the AIDS Consortium, an umbrella body for various NGOs, have seen Friends for Life joining the push for a national treatment plan.

Now that the government has agreed to the rollout of antiretroviral (ARV) drugs, the NGO is hoping to be at the forefront of community efforts to educate people about treatment.

Many of the NGO's staffers are also involved with the door-to-door project.

"We have to be part of it - this is a golden opportunity for us to educate people. Now that they are hearing that the ARVs are here, we need to push for treatment literacy," said Vernon Khuzwayo, a Friends for Life counsellor.

Khuzwayo has been in charge of the Ward 75 group since the campaign kicked off last week. "The problem is, there is a lot of talk now about ARVs and most of it is a whole lot of rubbish."

"Yesterday we met two HIV-positive guys from the hostel who told us that their inyanga (traditional healer) had warned them against taking the 'poisonous' drugs that government was going to provide, as they would lose their manhood," he said.

Counselling coordinator Mantwa Mohlala has heard worse: "The things people go around spreading are quite shocking. It's quite difficult trying to set the record straight, because when people are desperate they will believe anything."

Or sometimes they don't want to hear at all. As one group walked out of the centre's gates, a car stopped in the road and a formally dressed local pastor got out, demanding to speak to "someone responsible".

He said he was "fed up with these young kids speaking about things they know nothing about" and was going to tell people not to listen to them.

"In Alex as whole, there is still a lot of stigma. People think this campaign is a waste of time and we are just having a nice time. They see a young guy like me and think I'm just fooling around. They don't realise that all of us are directly affected - positive or not positive," noted Akanye Fungeni, another volunteer.

Twenty-nine-year-old Limakatso [last name withheld at her request] is HIV-positive, and has been living with the virus for the past 13 years without taking anti-AIDS drugs. She is employed by 'Friends for Life' as an HIV/AIDS educator.

"I've lived with this virus for a long time and I'm tired of living with it alone. Who knows, once I start taking treatment, maybe I can live [even] longer and find a husband in Bez Valley," she said. Bez Valley, a suburb in the east of Johannesburg, has been Limakatso's territory for the week.

However, with a CD4 cell (cells that orchestrate the body's immune response) count of about 300, Limakatso will not be eligible for the government's ARV rollout - one of the selection criteria is a CD4 count lower than 200.

She is also ambivalent about starting treatment. "I'm not sure. Sometimes, when I get really sick, I think it's time, but then there are times like now, when I'm so busy and healthy, I don't have time to be depressed about it. But it still hurts me that I won't qualify," she said.

Although she has not yet openly disclosed her status, she is more comfortable telling people on "a one-to-one basis". She hopes to show people that HIV/AIDS is not a death sentence, but has been getting an indifferent response from the mostly white Bez Valley residents.

"They either tell me to go away or call their maids to come and listen to me, as if HIV/AIDS does not affect them," Limakatso said.

"But my first day, when I told this old white lady I was positive, she said to me 'Oh you poor thing'. Then she asked me if I had any children and whether I was going to have any. That was so difficult because my heart gets so sore each time I think about it."

It's a catch-22 situation for Limakatso and many HIV-positive women. They want to have children, but do not want to have their child infected.

HIV can be transmitted from an HIV-positive woman to her child either during pregnancy, or during labour and delivery, or by breast-feeding. But the risk of transmission can be reduced in HIV-positive women who receive ARV therapy and appropriate medical care during pregnancy.

Limakatso has made her decision. "I don't want to have children like me, and I don't think my body will cope. Maybe I will adopt."

Another frustrating part of the campaign has been trying to make people see her, and all people living with HIV/AIDS, as "the same as everybody else".

"Even after all these World AIDS Days and door-to-doors, they find it difficult to think that Limakatso is still the same. I also want to be married and have a happy family. I also want love in my life," she said.

This was why it was so important to reinforce the issue of safer sex - even when people became HIV-positive.

"I'm a pensioner and people get embarrassed when I talk to them about sex. But the fact is, PWAs (people living with AIDS) must also have sex - it's a natural act, so we cannot keep quiet about it," commented Lulu Mantshu, a former nursing sister and now the NGO's 67-year old home-based care supervisor.

It was lunchtime and a few weary volunteers like Mantwa Mohlala had returned to the Friends for Life offices. "I would rather spend my time doing this [awareness-raising and education] because you see some small changes," she said.

Nevertheless, the progress made by the government and NGOs in HIV/AIDS prevention was still not enough, according to Fungweni and Khuzwayo. This, Khuzwayo pointed out, was brought home to him during the week's daily visits to the hostels in Ward 75.

"These are old traditional Zulu men who don't want to change. When we give them condoms and leaflets, they say they would rather keep the paper and not the condoms.

"We used to think it was funny but as each day passes, I get more worried," he said.

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