Fear and stigma in rural South Africa

The G8 has pledged extra funds for infectious diseases including HIV and AIDS. But a shortage of money is not the only barrier to HIV treatment. Fear, stigma and poverty are rife – and still claiming lives. Before coming to Germany, Zinhle Mapumulo visited one of many villages in South Africa where few are willing to discover their HIV status.

Mmabo Lefatshe looks petite, but in her village of Mazista - in South Africa’s North West Province - she is a well-respected and strong woman. I’ve visited a number of the country’s rural areas, but none compares to Mazista; the affluence you find in some parts simply hasn’t touched this corner of the country.

"Look at me today, I am alive and kicking..." Mmabo Lefatshe

The first thing I see when I enter the village is a cluster of about a hundred shacks squashed into a site suitable for ten or so houses. A few metres away a squatter camp doubles as a dumping ground for rubbish. Deeper into the village is Lefatshe’s house which belongs to the mining company she works for.

Lefatshe (39), Steve Modise (27), and Catherine Moya (51), were the first three people to disclose their HIV status in Mazista when the virus dared not speak its name. Many villagers called for them to be expelled, saying they had shamed the community by bringing this 'curse'.

Today the same people who were calling for Lefatshe and her counterparts to be banned are seeking advice from her on how to live with the HIV virus.

“God has a funny way of doing things,” she says. “The very same people who were spearheading the call for me to be banned are now the ones who think highly of me. One of them who was and is my friend, Kgomotso, was telling people that I got HIV through prostitution.”

“When her daughter, who has since died, became ill and later tested HIV positive, it dawned on her that the 'curse' had entered her home. The only person who is close to her and has some experience with the 'curse' was me,” she adds.

I walked around the village with Lefatshe, hoping to find another person who was willing to share their story to no avail. She insisted that a number of people in this village are in fact sick due to HIV or AIDS, but are scared to reveal it.

Health records show that only 21 people have taken an HIV test. Of these, six tested HIV positive and Lefatshe is one of five people receiving anti-retroviral (ARV) treatment.

“Anti-retrovirals saved my life,” she says. “I was at a stage where I was bargaining with God to take my soul because the pain I was feeling was unbearable. I was wasting and had developed sores all over the body. I couldn’t even walk let alone clean myself. But look at me today, I am alive and kicking.”

I was shocked to hear that Mazista village has no local clinic. For a community of about 1,600 people this was beyond inhumanity. “What is the North West government doing about this?” I ask.

“Nothing really, except making empty promises,” says Lefatshe. “People of Mazista have accepted that we are a forgotten village. Nobody seems to care about us. As you can see we don't have tar roads, water or electricity. The fact that the government mobile clinic comes once in two weeks shows that the situation in Mazista is not priority,” she explains.

After witnessing the effects of ARVs on Lefatshe a number of people hounded her for the remedy. They couldn’t believe that somebody who was on her deathbed could fully recover and actually return to work. Lefatshe agreed to share some of the drugs with her friend Kgomotso’s daughter.

“As a mother who lost her daughter due to AIDS-related illnesses and as a person living with the virus I felt Kgomotso's pain. I couldn't refuse because I knew that Kgomotso couldn't afford to take her daughter to a hospital in Swartrugens as she was unemployed,” she says.

When Lefatshe returned to the hospital a week earlier than scheduled because her dose had run out, the nurse told her she was putting herself and her friend’s daughter at risk because disrupting treatment can create drug resistance and potentially increase the risk of creating new drug-resistant strains of HIV.

Lefatshe has since stopped sharing her drugs.

The provincial department of health acknowledged early this year that the situation in Mazista village is disturbing and desperate. Health MEC (Member of the Executive Council) Nomonde Rasmeni vowed to act by ensuring a mobile clinic comes every week. She also promised to conduct some research into HIV and AIDS in the village.

But when I visited in May the mobile clinic was still visiting fortnightly and even though Lefatshe and her HIV positive friends are now no longer threatened with expulsion, the stigma still runs deep in Mazista village. Many people are still unwilling or unable to take the HIV test that could save their lives.

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