“You have brought the sickness:” HIV and a woman’s plight
By Lungi Langa
3 May 2010 | HIV/AIDS Awareness | AIDS Denialsm | Stigma
I was recently paging through a back-copy of the Big Issue magazine when an article titled Teen love gets more complicated, caught my attention. It told the story of a teenager who was born HIV positive. She found out about her status when she was thirteen years old.
Because she had been a sickly child, her mother knew every witch doctor around and took her to all of them.
Her father was also sick, convincing her mother that they were both bewitched, probably by one person. After her father died, the girl’s health continued to deteriorate until she was referred to a health facility where both she and her mother were tested and diagnosed with HIV.
The diagnosis finally reversed her mother’s view that the illness was linked to witchcraft.
While reading the article I tried to make sense of the mother’s state of mind. The belief she clung to for so long was a lie and now she had to make sense of it: they had not been bewitched, they were HIV positive. She also had to deal with her own diagnosis.
When I was growing up in Umlazi in Durban, it was not unusual to point out sick people and whisper that they had been bewitched. All of these “bewitched” people had similar symptoms. They had lost a lot of weight, their skin became darker as their illness advanced, they developed sores all over their bodies and got oral thrush. They walked around in a dazed slow motion and eventually had to be carried around because they could no longer walk on their own.
I knew many of these people and I could never understand why anyone would want to bewitch them when they had so little. After all, what did they have to gain from someone with so few possessions?
My failure to understand what motivated these bewitchings eventually lead me to a more scientific explanation for this disease. But the stigma associated with HIV still causes many to cling desperately to other explanations for their illness, including witchcraft. Transferring the blame to an outside force, something that is beyond their control, allows many to “cope” with an unexpected diagnosis.
In many communities HIV is still considered to be caused by a woman’s promiscuity. This dangerous assumption not only places the bulk of the blame on women but also enforces the misconception that only those who are unfaithful are infected, when often faithful women are infected by their unfaithful partners.
Whilst women may be disproportionately infected, it is widely agreed that their economic, physical and physiological vulnerability makes them more susceptible to infection than their male counterparts.
But for many women, blaming witchcraft offers a kind of safe haven. For them it is better to be a victim of witchcraft than to be accused of being a promiscuous, unfaithful wife who brought sickness into the family.
Sadly, blaming witchcraft to explain HIV infection in their families is unlikely to let women off the hook. Even if the husband’s family buy into the witchcraft argument, they are likely to continue blaming the woman, only not for infecting their son, brother or cousin, but for bewitching him. And when she falls ill herself, they may very well whisper that her “muthi” is turning against her.
Lungi Langa is a fellow with the HIV/AIDS and the Media Project.
Death and a Funeral
By Melissa Meyer
4 September 2009 | AIDS Denialsm | Healthcare | AIDS Politics
The newly appointed Minister of Home Affairs, Nkosazana Dlamini-Zuma’s public grieving over the suicide of a young man who took his own life after the Department of Home Affairs refused to issue him with an ID, has made for truly moving copy this week.
The sincerity of her actions aside, considerable credit is due to the minister for her level of involvement. At a time when some cabinet members are alienating themselves from the general population, splurging government funds on luxury cars, Dlamini-Zuma has shown her ability to identify with ordinary citizens when she attended Skhumbuzo Mhlongo’s funeral.
But there is something disconcerting about this ministerial display of empathy. If only Dlamini-Zuma had been this moved by the deaths of the many South Africans who perished from AIDS-related illnesses under her watch as Minister of Health, the South African epidemic may have taken a much less dramatic toll.
Opportunities for her to show empathy and bereavement in this context have certainly not been lacking. During her tenure as health minister from 1994 to 1999 there were more than 180 000 AIDS related funerals at which she could have announced:
“He was a sacrifice, but how many more do we have to bury before we can turn around this department and make it what is expected of it? Why do we have to meet under such circumstances before we can say something has to be done?”
And yet she only uttered these pensive, crucial words this week, at the funeral of Mhlongo. Regrettably, the department she was referring to was the Department of Home Affairs, not Health.
According to a 2006 study, the cumulative AIDS death toll rose from 10 133 in 1994 to 194 620 in 1999. As then Minister of Health, Dlamini-Zuma could choose from over a hundred funerals a day to give a tearful “never-again” speech of this nature.
Yet the minister was quiet. And the press, whilst dutifully taking the government to task for its bewildering policy and treatment lethargy, only rarely spoke about the death and the dying. There were no dramatic headlines with last words from the deceased or captivating photos of a crying minister that drew public attention to these deaths.
The health system failed these people the same way the Department of Home Affairs failed Mhlongo, yet they were never declared “a hero” in the struggle against AIDS the way he was made out to be a hero in the struggle for an Identity Document.
Whilst the minister’s tears this week may have been moving, her emphatic display was too little, too late.
Melissa Meyer is a researcher at the HIV/AIDS and the Media Project.
Manto backtracks on beetroot while Zuma preaches morals
29 September 2006 | AIDS Denialsm | AIDS Politics
It seems Minister of Health Manto Tshabalala-Msimang is not as impervious to public ridicule and pressure as she would have us believe. It appears she has denounced her famous diet alternative to anti-retroviral treatment. On 26 September, Sapa reported her as telling reporters at a media briefing:
“I challenge you to read all my statements and show me where this minister ever said it was an alternative. It is not.”
However, Tshabalala-Msimang did not completely relinquish her famous allegiance to beetroot, garlic and olive oil.
“It [nutrition] is not a substitute for medical treatment, but it helps in maintaining optimal health.”
In a recent interview with American Enterprise Institute for Public Policy Research’s Roger Bate, an economist who researches international aid policies in Africa and the developing world, Tshabalala-Msimang also denied having ever said her diet was an alternative to ARVs.
“We have never said that lemons or beetroot or garlic are therapeutically equivalent to ART. What we do say is that is that they contain micronutrients that make them valuable in strengthening the body to respond to certain health conditions associated with HIV and AIDS. A good diet, the right micronutrients, and a healthy lifestyle can help a patient infected with HIV stave off the onset of AIDS-related illness… But we never tell patients that diet can be a substitute for ART [anti-retroviral treatment]. It is important for a patient on ART to have a healthy diet.”
This is despite the fact that she never contested the numerous news reports about her promotion of nutrition in place of ARVs. In May 2005, the IOL quoted her as saying;
“When we were being pressured to use ARVs, we did warn about the side effects, and when I get reports about the people on ARVs nobody presents to me how many people have fallen off the programme or died because of the side effects.”
“Raw garlic and a skin of the lemon - not only do they give you a beautiful face and skin but they also protect you from disease.”
At one stage she was also a staunch and declared supporter of charlatan and “vitamin entrepreneur” Matthias Rath.
“I will only distance myself from Dr Rath if it can be demonstrated that the vitamin supplements that he is prescribing are poisonous for people infected with HIV,” she was quoted by The Star as saying.
In 2005 the Mail&Guardian reported her saying;
“There is no single clear intervention that can solely solve the challenges of people living with HIV and Aid. I know I get attacked if I say it’s nutrition or micro-nutrients or anti-retrovirals and people want me to say 'and, and, and'. I think we need to give South African options.”
Whether Tshabalala-Msimang is genuinely trying to bridge a communication break-down or save her own skin, the message is loud and clear: ARVs are effective in combating HIV/AIDS and good nutrition is not a suitable substitute. She knows she made a mistake and she must correct it. At least the people of this country will no longer be torn between listening to doctors and listening to a national minister of health. Interestingly enough, the media has not called Tshabalala-Msimang to account or taken her up on the challenge her challenge.
Director of the Aids Law Project, Mark Heywood, once said, “I know of a close friend who died because she was too scared to take anti-retrovirals … the minister should be disciplined by the ANC for her remarks.”
While Tshabalala-Msimang might finally be seeing the limitations of beetroot, another leader is continuing to practice hypocrisy unabated. Former deputy president Jacob Zuma was appointed as the main speaker at the launch of the Moral Regeneration and HIV/AIDS Campaign in Musina last week, Sapa reported.
According to co-ordinator Maxwell Nemadzivhanani, Zuma was chosen to speak because of the commitment he had shown in the fight against HIV/AIDS. This is the same Zuma who had unprotected sex with an HIV-positive woman and then claimed to have taken a shower in order to minimise the risk of infection.
“Zuma has shown a lot of commitment in fighting this disease and we thought it appropriate that he addressed the youth,” said Nemadzivhanani.
That Zuma was trusted to speak to 400 home-based care-givers who will educate the Musina community about the importance of having morals is cause for panic. The only chance the Musina community has of not being corrupted by this is if those care-givers are smarter than Zuma.
Hopefully the utter idiocy that has gripped our leaders and is enveloping this country in a dark cloud will start to lift and another 178 635 people can be added to the number of people on anti-retroviral treatment soon. – Akhona Cira
Manto madness must not sidetrack media
7 October 2005 | AIDS Denialsm | The Media and HIV/AIDS | AIDS Politics
With qualifications to her name such as a BA from Fort Hare University, a diploma in Obstetrics, a Master's Degree in Public Health from a Belgian university and a Health Care Systems Planning certificate from the United Kingdom, Mantombazana Edmie Tshabalala-Msimang is a reasonably qualified health minister. But test public support for this particular politician, and you're bound to get an earful.
As well-learned and travelled as she is, South Africans are less than pleased with Manto, who hasn't been in the public's good books since she took up her ministerial duties at the beginning of the Mbeki era. Despite this, she's been tenacious. She became a MP after the 1994 elections and took charge of the health ministry in 1999.
The health minister was in the news again this week. A Sunday Times article by Carmel Rickard and Claire Keeton reported the “ Constitutional Court's indignation at the way the minister had behaved in refusing to make submissions on the merits of her case to the Appeal Court .” The article noted:
“The attitude of the Minister of Health, Manto Tshabalala-Msimang, towards the Supreme Court of Appeal was this week described as ‘deplorable' and as ‘bordering on outright disrespect.'”
Tshabalala-Msimang, who is often referred to as “Doctor No” for her former refusal to administer antiretrovirals to pregnant mothers, has faced an array of court cases which in most cases she has lost. Has the TAC ever had to pay legal fees in a case against the minister, for example? A quick-witted journalist would do well to calculate the amount of taxpayers' money the health minister has spent paying legal bills defending the indefensible.
A second Sunday Times article by reporters Brendan Boyle and Buddy Naidu published on the same day and headlined “Manto roasted on Aids stance”, highlights the manner in which a former US ambassador Richard Holbook spoke of the health minister.
He (Richard Holbrook) then asked De Beers SA managing director Jonathan Oppenheimer: “But why [does] Manto remain? Why your President keeps Manto, who continues to give her monthly sermons on garlic and lemon juice, is beyond me.”
Holbrook was addressing an HIV/AIDS briefing, which the likes of John Kerry, a former US presidential nominee, tycoon Richard Branson, actress Angelina Jolie and Anglo American Chairman Sir Mark Moody-Stuart attended.
From the TAC's Zackie Achmat to South Africa 's Constitutional Court judges, from the official opposition to the international arena laughing at our Health Minister, it is safe to say she's unpopular at best, even hated by some. One could almost admire the resilience with which she clings to her post.
She has stuck with President Thabo Mbeki, whose indecision over HIV/AIDS has also lost him support and attracted much criticism. And what of her other dodgy ally, Matthias Rath? It appears now that that relationship is also under fire According to an I-Net Bridge report published in May, Tshabalala-Msimang has denied endorsing Rath, though other reports such as one run by Cape Times in June contradict this. (See the September 9 Journ-AIDS blog for more on Rath.)
It's unfortunate that media attention on Tshabalala-Msimang may have side-tracked real in-depth investigations into AIDS policy and implementation. When asked recently on SAfmwho his favourite comedian was, comic Mark Banks quipped, “Oh, Manto Tshabalala-Msimang!” Her outlandish antics are an easy target, but it would be terrible if they distracted the media's attention, even slightly, from an impending health disaster. – Lunga Madlala
Mice or humans?
5 September 2005 | AIDS Denialsm
German vitamin conman Dr Matthias Rath has set up two clinics in the Western Cape which lure people living with HIV/AIDS with food parcels and then trick them into being human guinea pigs, according to a Sunday Times article that appeared on September 4 2005.
Rath has reduced people to lab rats in what seems to be a crusade for money, apparently telling them to stop their antiretroviral (ARV) treatment and start taking dangerously high doses of vitamins instead.
Rath is running these clinics illegally – without the requisite approval from the Medicines Control Council to conduct a trial, and without registering its products, including Vitacor Plus, Epican Forte, Lysin C Drink Mix and Vita Cell.
According to the Sunday Times, the Rath Foundation hasn't even bothered to apply for the necessary registration. And, if the responses of other countries to his products is anything to go by, it would be unlikely that he would receive the go-ahead here:
“Germany and Switzerland don't allow the sale of Rath products because … the vitamin doses are too high for nutritional supplements, they haven't passed the necessary scientific trials to be medicines and the claims that they heal disqualify them as food products.”
The article, supplied by the credible Health-e News Service, goes on to point out that Rath's claims that vitamins are more effective than ARV treatment have been condemned by the World Health Organisation (WHO), UNAIDS, Harvard University, the SA Medical Association and the HIV Clinicians' Society of Southern Africa.
Rath, who founded the allegedly ‘non-profit' Rath Foundation in 2002, has made similar claims about vitamins curing heart disease and cancer in the past.
Rath established his two clinics in the Western Cape townships of Khayelitsha and Nyanga, which have been hit hard by the HIV/AIDS pandemic. People are lured to these clinics – ironically via recruiters from the South African National Civics Organisation (Sanco) - with the hope of being cured, or at least of living a better life.
According to the article, Sanco members have been acting as agents for the Rath Foundation, apparently being paid for every patient they lead to the foundation's doors.
If the HIV-positive “volunteers” knew that they were going to be asked to strip to their underwear and be photographed, would they have agreed? Would they have gone to one of Rath's clinics if they knew that they would be asked to stop their life-prolonging ARV treatment? Did those volunteers have any idea that this doctor and his institute are the only ones publicly advocating this new health plan, which even goes against research done by the exemplary Harvard University? With all this in mind, it would be hard to believe that many of these people would have sacrificed themselves for “Science”.
There has been plenty of opposition to Rath's approach, but desperation, and the hope that accompanies a new ‘miracle' treatment, can be almost too much to resist, even if we do know better.
Médicins Sans Frontières (Doctors Without Borders) disagree with Rath's findings and his campaign, according to an SABC news report in May 2005. This international NGO, which runs an ARV clinic in Khayelitsha, argues that ARVs are the only hope of survival for those at the onset of AIDS and that nutrition alone will not save one from dying of an AIDS-related illness.
The World Health Organisation (WHO), the United Nations Children's Fund (Unicef) and UNAIDS earlier this year all accused Rath in a public statement of irresponsibly, linking their names to claims that vitamins and nutrition therapy can prevent AIDS deaths. They all agree that vitamins alone cannot take the place of ARV treatment.
The Treatment Action Campaign (TAC) has also had several run-ins with Rath. The NGO served him with an interdict in May 2005, after he accused it of being funded by the pharmaceutical industry and promoting ‘extremely toxic' AZT (see the publicly denounced the Rath Foundation, saying that they will only endorse products which have been approved by the Medicines Control Council, and although they believe the vitamins to be advantageous, they believe that the public health vitamins which are provided for free are good enough, compared to Rath's expensive vitamins.
According to a TAC statement condeming Rath, advertising authorities in South Africa and the United Kingdom have ordered Rath to withdraw unsubstantiated claims. (See more about this in the Journ-AIDS treatment factsheet, under nutrition.) The TAC similarly notes that the Health Professions Council has laid a charge against him, because he has violated the Health Professions Act by running clinics in Khayelitsha and Nyanga, which are not registered. Furthermore, the NGO claims that Rath is under investigation by the German government for his role in the death of a young boy who died after taking his vitamins and not the prescribed medical treatment he was meant to be taking.
Even the Sunday Times is outraged by Rath's claims and actions. An editorial on September 4 2005 stated:
"we find it deplorable that one Matthias Rath is said to be pulling HIV-positive people off their antiretroviral regime and replacing these with dosages of vitamins. A number of people have already died.
It is our sincere belief that those who pull the antiretroviral lifeline from deserving people are guilty of murder."
The question begs: why is the government allowing a man to run private tests and research that hasn't been approved by the Medicines Control Council and that has been condemned by respected roleplayers in the ambit of HIV/AIDS both nationally and internationally?
While Rath has been condemned by senior ANC officials like Kader Asmal and Ben Turok, Health Minister Manto Tshabalala-Msimang has entered the fray by refusing to distance herself or her department from Rath. This is what she says in a report on IOLonline:
"I will only distance myself from Dr Rath if it can be demonstrated that the vitamin supplements that he is prescribing are poisonous for people infected with HIV."
Well, this goes a long way to answering the question posed above: denial, denial, denial. As long as it plagues our health department and senior government officials, poor people will continue to be used be used as pawns in this sickening game of political opportunism by quacks like Matthias Rath. - Lunga Madlala
