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

  Besides, the figure of six deaths surely becomes three or four, or eleven or twelve, depending on one’s vantage point. Whether an Ithangan believed that someone had AIDS depended a great deal on his proximity to the sick one. Sizwe knew that Jake had AIDS because they were intimate. Most people in the village believed Jake had been bewitched by his uncle. I would imagine that many AIDS deaths in Ithanga were characterized by similar uncertainties.

  THE SIX DEATHS Sizwe had identified remained his formative experience of AIDS until a Saturday morning in early February 2005. On that morning, the Médecins Sans Frontières treatment program came to Ithanga for the first time. By late afternoon, the meaning of the virus in Ithanga had changed forever.

  Ithanga is an outlying village, among the most peripheral in Lusikisiki. The nearest clinic is an arduous nine-mile journey. Dr. Hermann Reuter and his staff at the Médecins Sans Frontières office in Lusikisiki’s town center believed that the village had been sorely neglected. The program was more than two years old, yet the people of Ithanga knew little about it. A group of MSF counselors visited the local chief to ask his permission to set up a mobile HIV testing center at Ithanga’s school. The chief reluctantly gave his consent. MSF lay workers then spread word across the village that they would be staffing a testing center at the school for the duration of the following Saturday. The idea was to bring news of antiretroviral treatment to Ithanga.

  This is not the way Sizwe understood what happened that day. When he gave me his account he mentioned neither MSF nor ARVs. Indeed, he studiously refused to discuss ARVs with me until we had known each other a long time. For him, that Saturday had little to do with medicine; it was about shame and fear.

  “The whole village knew that people would be coming to test,” he told me. “The previous week, the young counselors had been all around the village telling everyone.

  “They came the next Saturday to set up their testing center at the school. Many, many people came to test, young people and not such young people. And to know who was positive and who was negative, you just had to stand and watch.”

  “For what?”

  “For how long the people stay. You see, there is counseling before the test, and counseling after the test. The counseling before the test, it’s the same for everybody: a few minutes. But the counseling after the test, for some it lasts two minutes, for others, it is a long, long time. They don’t come out for maybe half an hour, even an hour. And then you know.”

  “By the time the day ended, the whole village knew who had tested HIV-positive?”

  “The whole village.”

  “You went to the school to watch, not to test? You went to see who was HIV-positive?”

  “No. Not to watch. They said that you could come and learn without being tested. There was a room on the side, and if you went there, somebody would answer all your questions, but you would not have to be tested. That is what I did. I stayed in that room for maybe an hour.”

  The following morning, the people of Ithanga awoke to a different village. In the course of a few hours, eight or nine healthy, ordinary-looking villagers, most of them young women, had been marked with death.

  Such information is not easily absorbed. In the weeks and months that followed, those who had tested positive were silently separated from the rest of the village. They were watched. Nobody told them that they were being watched. Nobody said to their faces that their status was common knowledge. But everything about them was observed in meticulous detail: whether they coughed, or lost weight, or stayed at home ill; whether they boarded a taxi, and if so, whether that taxi was going to the clinic; above all, with whom they slept. These observations were not generous; they issued from a gallery of silent jeerers.

  “Not everyone scorns the ones who are HIV-positive,” Sizwe pointed out. “Some say they don’t care. They say it is the people’s disease, just like there is the cattle disease. It is here to kill us, whether we use condoms or not. So let’s just live. Everyone must just live until the disease kills us all.”

  “But others are scornful?” I asked.

  “It is a disgrace to be HIV-positive.”

  “Why?”

  We were walking from his father’s place to his shop. He stopped in his tracks and glanced at me anxiously. The look in his face was one of acute embarrassment, as if he and his entire milieu had been caught doing something shameful and nasty.

  “Is it not a disgrace where you come from?”

  “It was considered a disgrace from the very first,” I said. “A part of my research is to ask why it is such a disgrace everywhere.”

  He sighed with relief and started walking again. “Yo! It is very difficult to explain. I am not sure I know how…It will come. It is something that will come with your questions. You will see.

  “But maybe you can help me,” he continues. “We are confused. Is there a cure? Some say there is a cure in Durban. Others say down south.”

  “To my knowledge there is no cure,” I replied. “To my knowledge, the best medicine available is the one they told you about on the day they came to test: antiretrovirals.”

  He looked at me queryingly. “Yes?”

  “They do not cure you of HIV,” I continued. “But they stop the virus from multiplying. They keep you reasonably healthy. You need to take the pills twice a day forever, for the rest of your life.”

  I felt strange giving him this brief. We were having this discussion because MSF had come to Ithanga. He had gone to see the counselors and had spoken with them for a long time. He had clearly heard a great deal about ARVs, yet he acted as if he knew nothing of them.

  “Some people say there is a cure in Durban,” he said. “But it is a long way to go, and sometimes people talk rubbish.”

  I tried to swing the discussion back to ARVs. He would not go there. He delicately changed the subject.

  It was only much later, when we had known each other a long time, and I had pushed him relentlessly on it, that he told me what he thought of the MSF counselors who came to Ithanga that Saturday morning.

  “They reminded me of those religious cults,” he said, “of the prophet who comes to the village and says he has seen the light and you must follow him.

  “This is how the counselors sounded to me.” He stood up and donned the plaintive, high-pitched voice of a Sunday preacher. “I am living with this virus,” he said in his shrill, insistent voice. “I am living with this virus and I am healthy, I am strong. With these pills, the virus is dormant inside me. It cannot hurt me now. It cannot make me sick.”

  He regarded them, not only as a cult, but as a dangerous one. For what they were asking him to do was reveal his HIV status in the public arena of Ithanga.

  “What did testing day mean to you?” I asked. “What have you learned from it?”

  “That I must never test for HIV in my own village. If I test positive, I would be destroyed.”

  “How?”

  “It would be the end of my business, the end of my future. It would be the same as if my enemies tied me to a chair in front of my shop, and forced me to watch while they took it apart brick by brick, and carried away my merchandise item by item. That is what would happen.”

  “I HAVE NEVER told you,” Sizwe tells me a few days later, “that Jake’s family is one day going to lose another son. Last year, Jake’s older brother, Xolela, went to test. But he was scared to test here for the same reason I am. He went to a clinic on the other side of Lusikisiki where nobody knows him. He tested positive. He told me and maybe two other people.”

  “Did they do a CD4 count [a test of the level of immunity in his body]? Does he know when he must start taking drugs?”

  “He has not discussed that with me.”

  “Is he sick?”

  “He is often sick.”

  “Has he been back to the clinic? Will he take drugs?”

  “We do not discuss it. But I don’t think he went back to the clinic.”

  “Even when he was sick?�
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  “We don’t discuss it.”

  A surge of anger bolts from my stomach to my chest, taking me utterly by surprise. I feel my cheeks flush. “You know,” I say, “you live in one of the few rural areas in this country where you do not need to die of AIDS. At the clinic, Jake’s brother could start attending a support group, he could have his blood tested every six months, and when the time is right, he could start taking drugs. Why don’t you discuss this with him? It is a question of life and death.”

  He does not reply. We are sitting under a tree in an empty field. My car is parked some distance away.

  His silence makes me feel foolish. Until now, I have studiously replicated his muteness on the question of treatment. I do not know what it is he refuses to express, and I fear that if I begin to preach, he will forever censor himself in my presence. My outburst is a mistake. I have shut off a channel between us.

  His Father’s Child

  It was not until I learned of the circumstances of Sizwe’s childhood that I began to appreciate what an unlikely achievement his spaza shop signified. From the age of six or seven, the odds of him ever learning to read or write, or perform the arithmetic necessary to run a business, began stacking heavily against him. He has lived his current life in defiance of all he could ever have expected. In a place such as Ithanga, such a life is noted and observed, often with envy. A person is not easily forgiven for exceeding meagre expectations.

  Once I began to see the visible current of envy that Sizwe saw trailing him in his village, I began to understand his horror at the prospect of testing HIV-positive under the gaze of his peers and neighbors.

  SIZWE’S PARENTS HAVE long forgotten precisely when in 1975 he was born; both had little schooling, and Ithanga, then even more than now, resided on the margins of official recordkeeping. He has settled on December 1 as his birthday since his mother tells him she is confident it was in the early summer.

  He is the third of five children who survived childhood. The remains of his three siblings who died as infants and toddlers lie in unmarked graves in the corner of his parents’ mealie garden, about fifty yards from their kitchen. We pass the three mounds of earth every time we visit Sizwe’s parents, and he refers to them in a soft voice as his sisters and his brother. When Buyisile addresses his senior ancestors, he expresses his hope that his three dead children are well cared for and at peace.

  Of his living siblings, it is the first of his younger brothers, Mfundo, who dominates his memories of childhood, for the two boys shared the same life and the same fate.

  Foremost among the eccentricities they shared was their father, Buyisile. He was unusual primarily because he was there, all the time, throughout the year. In contrast to most of his peers, he stopped mine work after a single spell in Johannesburg, long before Sizwe and Mfundo were born. “Too much alcohol, too many men, too much fighting,” Buyisile told me. By profession he was for most of Sizwe’s childhood an inyanga, an herbalist, following in the tradition of his father and his grandmother. He specialized in treating barrenness in women, sterility in men, and later, in sexually transmitted infections. But his work as an herbalist never earned enough to feed the family, and seldom accounted for the bulk of his time. Around Ithanga, he was known for his physical strength, his deftness with an ox and a plow, and his unsurpassed skill at building homes from mud, cement, and wood.

  Here and now, at the beginning of the twenty-first century, South Africa’s social diagnosticians have identified the crumbling of the family as our most poisonous legacy. Many would smile benignly at the unusual image of two Mpondo boys and their parents living under the same roof in the early 1980s. The boys occasionally saw it this way, too. But in equal measure, they sometimes wondered whether they had not been cursed.

  WHEN THEY FIRST tried to go to school, Sizwe was eight, Mfundo six. It didn’t work. From the moment the first seeds were planted in October to the day the last crop was harvested in May, Buyisile’s cattle had to be tended. He did not allow his boys to go to school until early winter, almost halfway into the academic year. And then he took them out again just before end-of-year exams because the plowing season had begun and the cattle had to be tended again.

  “The teachers knew us,” Sizwe recalls. “They knew us as the boys who arrived in May. Everyone else had been in school from January. We were way behind. There was no time to catch up. We must do what the others are doing. And then when it was time to plow, we had to leave again.

  “Partly it was because we were quick learners, and partly it was because there were some teachers who were sympathetic, but often, for tests, we were given ten out of ten, when some other children were getting four or five. But there was this other teacher at that time, an old fat mama. When she was handing our test results back, she got to my paper and to Mfundo’s, and she stopped and looked at us, and in front of the whole class she said: ‘You have done very well in your test, you two boys. But am I proud of you? No. Because when it is time to write exams, you will be gone. It makes me sad to see these good results, because they are going to go to waste.’

  “She said this in front of all the other children, and it hurt. But she was talking the truth. We were making this effort to go to school, but why? We would never be able to pass grade one.

  “We knew this. We knew our time at school would not last, but it so happened that the way we left was directly because of our father. It was a day in October. My father came to look for us in school. He walked into the classroom, and he said he needed his boys, his boys must come now, there is work for them to do in the fields. After that day, I did not see a classroom again for maybe seven years.”

  THE DECISIONS BUYISILE made about his sons were not out of the ordinary for an Mpondo man of his times and circumstances. When he became a young father, a debate had been raging for several generations about what it meant to be an Mpondo in a land ruled by white Christians. And the question of the education of boys lay at the heart of this debate.

  During the course of the nineteenth century, in response to the growing presence of Christian missionaries in black society, a new binary opposition arose in the Xhosa and Mpondo languages: the ochre people and the dressed people. The ochre people were so-called because they donned the traditional blankets of the Xhosa and smeared ochre clay on their skins. (They were also known as the amaqaba, literally, “the smearers.”) The “dressed people” abandoned their blankets for European clothes. They were also known as the amagqobhoka, people who have been pierced through the heart, since their hearts had been pierced by Christianity: they were converts.

  The dressed people were vectors of European civilization. Their children were educated in mission schools, and were strictly barred from attending the formal activities of the ochre people’s children. They were taught Victorian sexual morality, railed against what they regarded as the scandalous sexual practices of the ochre people’s teenagers, and were married by priests. They built rectangular houses, rather than mud huts, and bought European furniture.

  For generations, the dressed people’s children were made acutely aware of the distinction between themselves and the ochre people. Writing about Pondoland in the early 1930s, the anthropologist Monica Hunter observes: “If when the dogs bark as someone goes past and a child is asked by its parents, who passes, a Christian child will say, if it be a Christian who has passed: ‘Ngumntu’ (It is a person); if a pagan: ‘Liqaba’ [a smearer of ochre]…”

  Sizwe’s parents both hail from ochre families. Ochre people’s sons seldom went to school for longer than two or three years. By the second or third grade, they had abandoned the classroom for their father’s fields and for the traditional children and youth associations. These associations were to fascinate anthropologists and historians, primarily because of their autonomy. No adults were present at youth association meetings. Older children inducted younger ones into work, play, fighting, and sexual conduct. Yet, despite the absence of an adult censor, they were remarkably conservative org
anizations. “The values they preach and largely practise,” the anthropologists Iona and Philip Mayer marveled, “are basically the same as their parents’ values; they include respect for seniority, preference for ‘law’ over brute force, and avoidance of pregnancy before marriage. The picture is therefore in sharp contrast to the alleged ‘generation gap’ of many contemporary cultures.”

  When Buyisile was a child, to join the youth association was almost synonymous with being an iqaba boy in a peasant community. Leaving school and joining the association was not simply an expression of poverty, or a lack of resources. It was an affirmation of a way of life. A boy who attended the association had a narrative of his adulthood carved out for him. He would imbibe Mpondo culture from his youth-elders; meet his future wife at a weekend association party; inherit fields and cattle from his father; begin to run a homestead of productive land; and settle into the life of a peasant patriarch. He would spend much of his adulthood migrating to the mines and thereby earning wages that would be invested in his plow and his livestock. He would live and die on the land of his ancestors; he would sacrifice goats and cows to attend to their well-being; and he would live under their protection.