A village story - the devastating impacts of the dreaded disease in poor villages!

In a previous blog posting, I confessed how I hold an idyllic view of rural villages – being originally from a rural village myself. The village in question here is in the Manyeleti (loosely translated as Place of Stars in the local Shangaan language) area, located on the north-eastern part of Mpumalanga Province in South Africa. This happens to be one of those few places where I can marvel at the unblemished sight of starlit skies at night, with a clear view of the Southern Cross and the radiant Pleiades (called Xirimela in the local language). When the weather is clear, one can behold the sheer glory of the silvery stars and smile. As the famous poet once narrated, “earth has not anything to show more fair…dull would he be of soul who could pass by a sight so touching in its majesty.” That is the sense of awe one gets when gazing at the skies at night down in the Manyeleti area.

But there is a storm brewing in this area. It was not that long ago that informed people sounded out warnings about the impending doom that would be brought about by HIV-Aids. The narrative at the time warned us that HIV-Aids would devastate large swathes of South Africa, especially the much poorer areas where people do not have the inherent adaptive capacity to survive shocks and nasty surprises. We paid little attention at the time and simply laughed off the warnings thinking Aids was something affecting rich people in far off places like Johannesburg. Unbeknownst to the poor village people, the monster was lurking in the shadows waiting for the right moment to pounce.  This then is a chilling story from a humble village not much different from other villages in South Africa.

There once was a quiet sleepy village..

You’ve probably known places like the one I’m writing about here. People get on with their lives and hold fast to common beliefs and ways of doing things. Traditional practices hold sway. People carry on with life drinking traditional beer and harvesting vegetables from the fields. One can get by on a pittance here.

So it is in this relatively quiet backdrop that the monster crept in. The disease completely obliterates villages and the traditional life set-up. The poor villagers go about their normal practices of going to local shebeens for traditional beer and a good time. After a few drinks, they start frolicking with local ladies. One thing leads to another, and the inevitable happens. This is the typical setup in most of these villages. So the pattern of infection multiplies. Their poor wives back at home are none the wiser and get infected as well.  So it all becomes a sad chain reaction. When the husband or wife gets sick, they are completely clueless about how to deal with their condition, even with the ready supply of antiretroviral drugs in public hospitals and clinics. 

It turns out one needs to understand exactly what they are dealing with in order to be able to stick to a treatment plan and make suitable adjustments in their lifestyles. This seems to escape the poor country folks. Blame it on their traditional practices. Blame it on the never-ending stigma associated with HIV-Aids. Or on lack of education.

Even worse, the poor people become easy targets for opportunistic preachers and spiritual healers who promise instant solutions. They get swindled out of their hard earned money by these shameless vultures. These are desperate people of course, the sort you’d convince and sell a magic potion to. Instant solutions sit well with their beliefs. After all, claims about traditional doctors who’ve mastered some cure-for-all ailments refuse to die. The poor village people swear by these stories. Except the stories aren’t true. Desperate people do not have much to cling to in a storm. They’ll hold fast to anything that gives hope, however outlandish.

These poor people can’t be trusted to stick to doctors’ prescriptions faithfully, which is pretty much what is required with antiretroviral drug treatment. And that is the real cause of the tragedy.

So is there a way out?

In the long run, there should be. Organisms that do not quickly adapt to changing conditions eventually lose out and get eliminated. They do not get to contribute their progeny to future generations. Forgive me for being crude here, but that’s the way natural selection works. That is probably the fate facing many poor people from the villages.

The sad thing is that hardly anyone needs to die of Aids these days given the treatment options available. But people do. This is owing largely to plain ignorance, or a lack of understanding about the nature of the beast they are dealing with. And there is the little matter of a clash between prevailing Western scientific knowledge and the cultural traditions. The ordinary villagers find all these things befuddling. They can’t faithfully stick to a treatment plan or doctors’ prescriptions. If they feel better after taking medication, they tend to toss the pills aside and stop with treatment altogether. After all, what’s the point of taking pills if one is not feeling sick? And if the magic potion guy shows up with his cure-for-all, the poor village people will likely believe him. One can spin theories and sell them to these folks. So the tragedy really lies in not having enough understanding to deal with complex matters and choosing to act in old established ways. No wonder so many of them die.

I walk down the streets and am scared of asking about people I haven’t seen in a while lest they be among the departed. This cuts right across the board; from the old, the young, and the happy beer-drinkers who crowd the local shebeens. Incidentally, the shebeens are the killer corners where the fate of many families has been written. Most shebeen regulars have died. Many more will. The villages are places of dysfunctional families headed by orphans. Most of them are places of little hope. The government should surely think of a plan to save these families? Something’s got to give. 

We can blame it on those many years of foot-dragging by the government during Madiba’s and Mbeki’s tenures. We are certainly paying a very high price. This has got to be front page news. I wouldn’t be overly surprised if the population of the country has flattened somewhat (or probably already decreased in some hard-hit areas). We probably have immigrants to thank in those areas reporting rising populations.

The short end of the stick!

I would argue that the village people got the short end of the stick through no fault of their own. This was owing to conditions they find themselves in, which they can’t make much sense of. So what’s gonna become of their lot? They are already faring badly. The dreaded disease can only worsen things for them. It will be interesting to examine the villages years from now to see what effects the marauding monster has had on them. I’m not saying this as a pessimist, but as one with a vested interest in the poor villages. I would want to see them develop and grow and succeed. But I fear the dreaded disease is running the show here. Fate has dealt these poor people a nasty deuce of spades. And their capacity to adapt seems stretched beyond limits.  The types of businesses that thrive in this area are those connected with death; the macabre type-businesses (funeral parlours, hiring out of tents, etc.). You make your money when other people grieve the loss of their loved ones. Very chilling indeed, but this is a fact of life in the Place of the Stars.

 

A dose of uncomfortable truths

I have seen hell, and it’s got an ugly face. I’ve seen hell in a place called Manyeleti, which is part of the idyllic lowveld area. This is an area with beautiful star-lit skies at night with a much clearer view of the Southern Cross and other silvery stars. This is the place with the highest infestations of the dreaded disease that I’ve seen anywhere. The Place of Stars is part of the wider Bushbuckridge Municipality, which itself is a microcosm of conditions in poor rural areas in Mzansi. The government’s attempt to roll out free antiretroviral drugs, though well-meant, seems to have very little effect here. Unsurprisingly the rate of HIV-Aids infections in the country remains stubbornly high despite all the best efforts of government and civil society according to the latest findings by the Human Sciences Research Council. A few people benefit here and there, but even my poor mom can attest that we seem to be slowly losing the war on the dreaded disease. Some people do take the drugs and stick with the treatment plan, but a great many abandon the prescriptions after a short while and sadly die.

It makes no sense why people would continue to die in their numbers when drugs are available. But a cross section of the area reveals some uncomfortable truths. One of these is the traditional practices the poor people cling to. These practices must be done away with. Or better still, the traditional practices ought to be held up to the light to expose the cracks. Absence of knowledge is the biggest deterrent to progress. Sadly, natural selection will drive for the exclusion of unfavourable traits which hold our species back. One of those traits will surely be the absence of knowledge, which reduces our adaptive capacity as a species.