Sizwe's Test: A Young Man's Journey Through Africa's AIDS Epidemic Read online

  Rage like Mbeki’s is all over Lusikisiki. Where there is AIDS, there is blame. It is said in the villages that the virus was hatched in laboratories, to be let loose on blacks until whites become an electoral majority. And the accusations are not only racial, not only overtly political. The ill are accused of having murdered loved ones by their promiscuity. Neighbors are blamed for using magic to infect the beautiful and the successful. The accusations expressed in national politics are also stitched into village life, and, indeed, into individual consciousness. On one level, this book is an exploration of the place of blame and resentment in one man’s decision whether to test his blood for HIV.

  I VISITED LUSIKISIKI periodically over a period of eighteen months. After meeting many people—nurses and patients, traditional healers and treatment activists—I decided to research much of the book that follows by sitting on the proverbial shoulder of a man I shall call Sizwe Magadla. He was almost thirty years old when I met him. His child was growing in his lover’s womb, his family was negotiating bridewealth with hers, and he was preoccupied with imagining the course of the remainder of his life.

  On the day I clapped eyes on him, Sizwe was healthy and strong and had never tested for HIV, which puts him in a category shared by most South African men his age. That is why I chose him. In this narrow sense, and no more, he was an Everyman, and it was his perspective on the antiretroviral program that I wanted to understand.

  The MSF project run by Hermann Reuter has only a peripheral place in Part One of this book. That may seem odd, given my motivations for writing it. The reason is that I wanted to approach antiretroviral medicine from Sizwe’s vantage point, and when I met him, it was no more than a distant presence for him, one that cast a troubling shadow over the very edges of his world. The meaning of AIDS in his life had a good deal more to do with being a son, a prospective husband, and a shopkeeper than living in a district that administered antiretroviral drugs. I needed to show how the treatment program entered his life and wrestled with his other preoccupations.

  As we began touring Lusikisiki’s clinics, Sizwe came alive to the sheer scale of the illness that he had been seeing around him for some years. The more he witnessed, the more the prospect of testing his own blood for HIV frightened him. That he saw people taking pills and getting well did little to alleviate his fear. What follows is a chronicle and an exploration of that fear.

  I have given him and his village pseudonyms and tried to disguise them both. That is a crucial feature of this book. A story about shame is also about privacy, for who wants others to witness their shame? And yet precisely what privacy means in the midst of an epidemic of shame is far more complicated than I ever imagined.

  PART ONE

  Sizwe

  I met Sizwe Magadla in the spring of 2005. I was looking for him because I hoped to meet his father. Some weeks earlier, I had put out word that I wanted to get to know an igqira, a diviner-healer, from one of the remoter villages of Lusikisiki. Someone had told me that there was a young man from a village called Ithanga with a spaza shop—a ubiquitous presence in rural South Africa, where customers buy everything from headache powder and baby food to cold beer—and that his father was an igqira.

  When we finally met, it was, ironically, on the premises of one of Sizwe’s competitors. There is a spaza shop some distance from the edge of Ithanga, about fifty yards before the gravel road ends. It is about the only building in the vicinity of the village that one can access by public road. I went there accompanied by a man called Luyanda, whom I had hired as a translator and a guide. He was in his late forties, had been coming to the Lusikisiki area since he was a child, but had never before set foot in Ithanga.

  We parked our car, walked in, and asked for Sizwe by the description I had been given: the young man with dreadlocks who owns a spaza shop and whose father is an igqira. The woman behind the counter nodded. She called over a small child and instructed her to go into the village to call him. The child dawdled out of the shop reluctantly, scraping her bare feet against the floor, and made a slow journey into the village.

  We waited. Opposite us was a group of young men. There were seven of them. Four sat languorously on the chest-high shop counter. The other three stood leaning against the wall. They had about them an aura of short-tempered proprietorship, as if they were waiting to be entertained but were very hard to please. For the hour or so we inhabited the same space, they managed both to take much interest in us and to ignore us.

  After waiting for some time, we decided to stretch our legs. Out in the sunshine, I told Luyanda that if the spaza shop man did not show up soon, we should leave. I would come back alone the following day, ask for directions to his shop, and make my way into the village on foot.

  “Please don’t do that,” he said. “Not alone. Those boys…You will be carrying a bag. They will want your bag.”

  I shrugged. “I’ll leave my bag in the car.”

  “Please,” he said. “I know boys like those. They have spent time in Durban or Port Elizabeth. They have guns. When they come back to the rural areas they feel they can do anything. They are feared.”

  And so my first impression of Sizwe’s village was of these sullen young men idling dangerously through empty time, of souls with unknowable futures and great, wide stretches of the here and now to be filled. I was to learn that they were indeed feared, not least by those who had known them since they were infants.

  SIZWE APPEARED JUST as we were about to leave. At first he did not see us. He came into the shop, walked past us, stopped, turned around, and looked at us inquiringly.

  He was strikingly beautiful. He had a wide face, his cheekbones high and carved, his mouth thick and full. He took us in with eyes that suggested he inhabits his own skin, that he has no urge to drift or to wander. His hair was braided into thick dreadlocks that fell off the sides of his face over his ears and onto his shoulders.

  He shook our hands solemnly, took three plastic chairs from the shop, and put them out in the sun. We sat, and I told him my business: that I was writing a book on AIDS, that I wanted to meet his father and get his views on the virus, that I sought to ask his father if I could watch him work.

  When I had finished speaking he held out his forearm and shaped his hand to hold an imaginary syringe. “I have not tested,” he said. “My girlfriend is pregnant and she went to the clinic to test. She’s negative. Do you think that means I’m definitely negative?”

  I was taken aback by his openness.

  “If you want to know, you must test,” I said.

  “I know,” he replied. “But I’m scared.”

  He smiled at me and laughed, got up, motioned for us to get up, too, and took our three chairs back inside.

  I met him the following day at the same place, and we walked into the village together. At first he was somewhat stiff; the previous day’s levity appeared to have abandoned him. Sometimes we spoke, sometimes there was silence. At some point I noticed a subtle change in his gait and his footsteps. He was beginning to relax. As he did so, he began to ask me one question after another: why I was writing this book, what precisely it was I wanted to learn. His interest in me was neither watchful nor suspicious; I had arrived from a world he knew little about, and he wanted to imagine the place I had come from. By the time we reached his parents’ homestead I liked him. He possessed a curiosity both rare and distinctive; one recognizes it the moment one sees it. It is the curiosity of a person who has no interest in confusing the boundaries between himself and others, who does not identify or envy too much.

  I SPENT THE following two days with Buyisile, Sizwe’s father. He was over six feet tall, with the taut, muscled body of a man less than half his age and a temperament capricious enough to make me uneasy. He was a great performer; when he spoke he possessed the space and the people around him. He told story after story, entertaining both himself and the adults and children who wandered through his household. And then, without warning, his face would drop, he would
grow silent, and he would begin to sulk. As with his stories, his dark moods took up space: they suggested that he had both disappeared deep within himself and wanted to take those around him with him.

  Throughout the two days I spent with Buyisile, Sizwe was quietly present. When I took his father to see a patient an hour’s car journey away, Sizwe was in the backseat. When I sat in Buyisile’s great rondavel listening to his stories, Sizwe would sit next to me. He seldom spoke. He would bow his head and allow his dreadlocks to fall over the sides of his face and cover his eyes. It was difficult to know what he was thinking. He was, it seemed, in another’s space, that of his father; his thoughts, I imagined, must remain private here.

  I listened to Buyisile’s stories, recorded them faithfully, and learned a great deal. But I wanted to move on. He had, I imagined, a limited stock of tales, and beyond them he was impenetrable to me; his words seemed a thick buttress, one I feared I would never skirt.

  At the end of our second afternoon together, we were sitting in Buyisile’s rondavel, about half a dozen of us, listening to him talk of the forests and the medicines it harbored. He told us of how, when he was a boy, his own father would take him into the forest and teach him about herbs, how his father’s mother had done the same, how his knowledge of Ithanga’s forests was the inherited knowledge of several generations.

  Sizwe and I were sitting close to each other on a bench. I asked him if he too would one day take his unborn child to the forest to teach him about herbs.

  “I am not sure how much longer I can live here in Ithanga,” he said quietly.

  I looked at him, my surprise at his sudden declaration clearly showing in my face.

  “Where do you want to live?” I asked.

  “Somewhere I am not known. Where you are known, you cannot run a business. People see you through your parents and your grandparents and they judge you. They ask how a man can be successful when his parents are poor.”

  “You want to come to Johannesburg?”

  “No. People go to the city and they live in shacks alongside strangers and they come home sick. I am not going to the city.”

  “Where then?”

  “In Lusikisiki, but another village: somewhere I am not known.”

  “What are you afraid of? What is it you think people might do to you?”

  “There have been things happening in my sleep,” he said, looking down at the floor. “Twice now, I have woken up in the morning and I have been wet and sticky. I am twenty-nine. Wet dreams are for boys, for when you are maybe thirteen or fourteen. I have Nwabisa sleeping next to me. I am a man.”

  “So what is happening to you when you sleep?”

  “Some people have maybe sent a demon to have sex with me: a demon with HIV. That is why I am scared to test. I think I will test positive.”

  At the time of this conversation with Sizwe, I was taken aback by what appeared either to be a confessional outburst or a moment of exhibitionism. I couldn’t decide which. I asked him immediately whether I could write about him. He told me he would think about it; it took him more than a month to say yes.

  Ithanga

  Pondoland is a place of abrupt changes, of moods you have not expected: the spirit of the place is hard to pin down. It is not just its short-tempered, unstable weather. It is also a question of topography. As you drive away from the Umzimvubu River, the world outside your window is close and intimate. The horizon is seldom far, yet between yourself and the end of what you can see the land buckles and drops way below you and climbs to heights far above. The result is a sense of worlds on top of one another, instead of side by side. Looking out to the horizon, you are accosted by the feeling that your horizontal gaze is misguided or out of focus, that you are missing almost everything in between. Turn a corner or climb a hill and you find yourself in a village or a pasture of which the view from your window did not warn.

  And so it is with Ithanga, the village in which the last five generations of Sizwe Magadla’s paternal forebears were born and bred. There is no vantage point from which to see it; it is a place you first witness from close range. You take one of the dirt roads from Lusikisiki’s center and drive for about twenty miles through a varied landscape of thick forest and naked hills. From the summits of the tallest hills you can glimpse the ocean. After some time, the trees disappear and the land flattens. You turn a bend and suddenly you can go no farther. In front of you there is a barbed-wire fence, and on your left a very steep, rutted road. Unless you have a four-by-four, you must leave your car and climb it on foot, about three hundred yards. It is arduous; when you reach the top there is sweat on your brow and you are breathing heavily. I always associate the sight of Ithanga with the sound of my own breath in my ears.

  It appears quite suddenly and unexpectedly: a deep valley surrounded by green hills, clusters of round mud huts and square, tin-roofed structures at the summits, a river flowing through the basin. The river bisects the village. To visit a neighbor you take off your socks and shoes and you wade. Cows and goats and pigs graze on the slopes and come down to the valley bottom to drink. The hills make of the valley an acoustic amphitheater. You cannot always see children, but you always hear them, exclaiming and shouting and crying, as if somebody has piped a recording of a crowded school ground into the village and plays it over and over.

  SIZWE LIVES ON a perch near the top of one of Ithanga’s highest hills, about a half mile from his father’s place. Standing at his front door, you tower above the village, the horses and cows in the valley basin mere stick figures. He built much of his house with his own hands, using wood from the forest, mud from the riverbed, several dozen bags of concrete from town, and corrugated iron for the roof. He erected the frame, put on the roof, and then grew bored with the work and hired a man called Stars to finish it. He did not like Stars’s craftsmanship. Every day he watched Stars work he grew angry, but said nothing.

  “What can I do?” he said to me. “In this place, you must not be quick to fight. Stars comes and works for me. Stars fucks off. I greet him every day, but I never use him again.”

  This is indeed a place where one must not be quick to fight. There are only seven hundred souls here and one sees most of them every day.

  “Do you know each person in this village?” I ask Sizwe.

  “Everyone,” he replies.

  “By name, by sight?”

  “By everything. By their parents, their grandparents, their cousins. Maybe someone new comes and for a while I don’t know them. For a week, maybe. Then I know them. And I know how they fit in.”

  And everyone else, of course, knows Sizwe, and has his own sense of how Sizwe fits in. Among the things everyone knows is that when he was a boy his family grew very poor, that he was once lean and quite literally hungry. They know too that Sizwe is no longer poor; he owns a spaza shop at the age of twenty-nine, and in this village that is no mean achievement. It puts him head and shoulders above just about all his peers. That is not something that courts unalloyed joy. The path from poverty to success is watched and noted, and not always with generous eyes. More than most residents of this place, Sizwe must not be quick to fight.

  HIS HOUSE HAS two rooms. He and Nwabisa, his lover and the mother of his unborn child, live in one of them. It has a double bed, a wardrobe, and an interminable collection of kitchen utensils. It also contains two very large books that lie on top of each other on the windowsill: a comprehensive edition of the Roberts’ Birds of Southern Africa, and an Oxford dictionary for second-language English speakers.

  Sizwe’s English is sound, but some of it he learned alone, in the small hours by paraffin light. His speech sometimes oscillates between the colloquial and the technical, as when he speaks of a neighbor who was kicked by a horse in the testes. English is a weapon he sharpens nightly; he knows that Ithanga and the fate of its people are connected to the larger world, and that he must confront it appropriately armed if he is not to get hurt. Yet he also believes English to be dangerous. Five generat
ions of family lie beneath the ground of this village, and to drift from them would be to drift from himself. Embodied in the vocabulary of this language, he thinks, is a force of great corrosive power, one that has been eating away at the substance of his family since his grandfather’s times. Sometimes he believes that in studying English too well he will imbibe its destructiveness, that too much learnedness in the head of an Mpondo man will quite literally drive him insane.

  The other room in his house is his spaza shop. A chest-high counter runs across the length of one side, and behind the counter there are shelves from floor to ceiling. They display an eclectic assortment of wares: headache powder, baby food, breakfast cereal, potato crisps, washing detergents, loaves of bread, matches, candles, tins of pilchards and baked beans, a rack of chickens. Everything is tightly packed in an ordered flamboyance.

  On the floor, wedged between the shelves and the counter, is a large fridge. It is filled with bottles of beer. It accounts for more than half of Sizwe’s income and most of his trouble.

  “I am a person who must deal with the difficult side of people,” he tells me. “That is my job. That is how I make a living.”

  Most households in Ithanga are supported either by the state pension of an elderly person, or the meagre wage of a family member working in the tourist industry on the coastline or in the state forests. Those with money to spend are, disproportionately, people in their sixties, seventies, and eighties, since they are the only Ithangans guaranteed an income, courtesy of the state. Old men and women shuffle into Sizwe’s spaza shop in the midafternoon, sit on stools drinking stout and listening to Maskanda, a modern form of Zulu folk music, on his hi-fi, then drift away after sunset.