THE NEW SOUTH AFRICA

(Published in the Esst Bay Psychiatric Association Newsletter, April 2007)

This past February, my wife and I spent 10 days touring 3 major cities in South Africa: Johannesburg, Cape Town, and Port Elizabeth. We went on a Study Tour with The American Jewish World Service (AJWS). This charitable organization provides funds as well as volunteer and technical assistance to grassroots organizations in the developing world. It helps support over 300 projects in some 36 countries in Asia, Africa, and South America. We visited about a dozen such non-governmental organizations (NGO’s) in an effort to understand their efforts in combating the HIV/AIDS pandemic now ravaging South Africa. One thousand people a day are dying there from this disease, and twice that many are becoming newly infected daily.

I knew little about South Africa prior to this trip, outside of its history of apartheid. I learned that from 1948 until 1994 blacks not only had no vote, but that they also were deprived of any meaningful education. In 1994 after South Africa became a democracy and freed itself of their racist white government, blacks were left uneducated, unskilled, and living in townships where they had been forcibly moved, in conditions of abject poverty. Shacks housing millions of people with little or no amenities or employment opportunities stood on the outskirts of the cities we visited. These slums were worse than anything I could imagine, although I have since learned that 1 billion people worldwide, or more than 1 in 7, live in such conditions. I was unprepared for what I saw, and my emotions welled up inside me more than once.

Nearly 19% of South Africa’s adult population is now HIV positive. The Mbeki government made things worse for a time as they denied the link between HIV and AIDS and promoted folk remedies and stood in the way of people getting the Anti-Retroviral Drugs (ARV’s) critical to controlling the virus. Conditions in hospitals were unlike anything we westerners are familiar with. In one hospital, I saw hundreds of people filling every nook and cranny waiting to be seen. The AIDS clinic opened at 8 am and closed at 4 pm that day. People started queuing up in the early morning hours in hopes of being seen. The elderly would have someone younger in their family hold a place in line for them until the clinic opened. If you were fortunate, a health worker would examine you and report to the single physician manning the clinic that day so that you could receive medication and/or other treatment. If you were not so lucky, 4 pm would roll around and you would go home to start the same process again the next day.

In South Africa HIV/AIDS is primarily a disease of heterosexuals, transmitted in the black community by the men who do not acknowledge their HIV status, to the women they have sex with, either consensually or forcibly. The ABC’s that are being taught to the populace are “Abstinence, Being Faithful, and Condomizing.” Because of the overwhelming number of AIDS deaths every week, and because funerals are held only on Saturdays and Sundays by custom, weekends are consumed with funerals, and the graveyards are fast filling up.

Because we were traveling with a group that helps support the agencies we were visiting, nearly everywhere we went the workers greeted us with songs in their tribal dialect with beautiful South African rhythms and harmonies. One Sunday we went to services in a Church in the townships and heard perhaps 1000 such voices singing Gospel songs. Even for a non-believer like myself, it’s difficult to imagine that the beauty of these voices was not being heard on high. It was a powerful spiritual experience.

Every time we witnessed situations that seemed overwhelming and made me feel hopeless, we would meet ordinary people doing amazing work to overcome the double scourge of the residues of apartheid and the current blight of AIDS, and I’d feel hopeful again. We met exceptional human beings throughout our trip, but of special note were three people from three different generations: Helen Suzman, age 89, was the leading voice in the Parliament for 35 years speaking out against apartheid; Helen Lieberman, age 63, a social worker in Cape Town, founded her own NGO, Ikama Labantu, and has devoted her entire adult life to providing social services for blacks despite enormous personal danger to herself for doing so; and Jacob Lief, a precocious 29 year old American, has set up his own extensive non-profit social services organization in Port Elizabeth and demonstrates the acumen of a corporate CEO in dealing with his complex organization.

We drove down the only street in the world where two Nobel Peace Laureates reside—Bishop Desmond Tutu and Nelson Mandela. The prestigious international recognition of these two contributors to overcoming apartheid signifies the importance that others have attached to building a new South Africa.

South Africa looks very much like the United States, unlike what I felt when I was in East Africa some 10 years ago where everything there looked different to me—the sky, the landscape, and the cities. But in South Africa, I felt at home. Johannesburg was like New York City, Cape Town felt very much like San Francisco (including having its own wine lands an hour away), and Port Elizabeth was a lot like many moderate sized beach towns along our coasts. The country is a mix of first world western conditions contrasted with, and lying adjacent to, developing world conditions. It’s a country worth visiting for many reasons, not the least of which is that it is on the brink and needs our help. I encourage you to go there and to educate yourself about this vast land on the opposite side of the globe half surrounded by the Atlantic and Indian Oceans. You won’t regret having made the effort. It’s quite a place to behold and a place worth saving.


--Hugh R. Winig, M.D.