Siphiwe Hlophe is so huge that when I came to give her a hug to say goodbye I couldn’t get my arms round her. “Well, at least you don’t have Aids,” I said. That sounds an appalling thing to say, but in Swaziland Aids is such an overwhelming fact of life – and death – that people who work on Aids projects make jokes about it all the time. Hlophe laughed. “But I am HIV-positive,” she said, as straight as a bullet.
She had just turned 40 in 1999 when she won a scholarship to study agricultural economics at Bradford University. She has four children, the eldest 22 years old and the youngest 11. A condition of the scholarship was that she took an Aids test, which she did, believing there was no reason to be worried. She was stunned to find she was HIV-positive. Her husband left her immediately, she lost her scholarship and she thought she was going to die. With the help of friends, she came through the trauma and decided to do something for people living with Aids. She formed a group called Swapol (Swazis for Positive Living). It now has 150 members, mostly HIV-positive women.
Swapol women have the camaraderie and swagger of conquerors. They walk the hills of Swaziland visiting terminally ill people in their huts, trying to ensure they get medical care, providing trained counsellors and advice on diet. They battle with the myths and ignorance that surround the disease and even more with the widespread prejudice against those who are its victims. Many households they visit typically consist of a 15-year-old looking after three or four younger siblings and a seventysomething granny. Everyone else has died. Such a family does not have the physical strength to dig enough land to feed itself. The Swapol women are building fish ponds and beehives and have recently begged a piece of land to grow vegetables. Hlophe laughs. “We are so busy. Now I’m going to live to my retirement.”
I met Siphiwe Hlophe on the first day of a tour of southern Africa to visit Unicef-funded projects for people living with Aids, and as I moved around the region, I realised that she was not alone. Wherever there were serious attempts to halt the spread of Aids and support those affected by the disease, I met women who seemed to have been transformed by the discovery that they themselves were HIV-positive. Each of them had gone through shock, grief and rage and then come to accept they would die soon. But they decided that, before they left this world, they were going to change it. Catastrophe makes ordinary people do extraordinary things and these women had lost their fear. They had become extraordinary through Aids.
Aids in Africa is killing more people, more quickly than any catastrophe in the history of humanity. Only a tiny proportion of people in Africa have heard of, let alone can obtain, the anti-retroviral drugs that can keep Aids sufferers in rich countries alive for years, if not decades. Aids has already killed 13.7 million Africans, twice the population of London, and more than twice that number will die of it by 2020. Already there are about 13 million Aids orphans, and that figure is expected to double by the end of the decade. Infection rates may be levelling off, but the death rate can only climb for the next few years. In much of southern Africa, about one in three is HIV-positive. The famine in southern Africa this year will be more deadly because so many breadwinners or homemakers are too sick to work or collect water and firewood.
Figures cannot convey the horror of this plague. Close to it, you see how Aids kills painfully, slowly and inexorably. There are good days and bad days, but it is only a matter of time. Lives are squeezed into years rather than decades. What matters is your attitude to that time and what you do with it. When I knocked on Helen Mhone’s door and asked her for an interview, she looked at her watch and said I had 13 minutes. A set time? In Africa? Not even dictators do that in Africa. I protested. Mhone shrugged: “With Aids, time is essential,” she said.
She was already 40, working as a manager in a hotel chain when she discovered she was HIV-positive. She had three grown-up children and was divorced when someone close to her died of Aids. “I went for a test and I was positive . . . I had always thought Aids wasn’t for me, so I went through all the stages: shock, disbelief, rage, blame, grief. Then I went to a conference for people living with Aids. I decided to do something about Aids.” Mhone was the first woman in Botswana to admit she was HIV-positive. “I found a lot of people came to consult me, and the government used me to educate people about Aids.”
At the Aids conference, she met a man of her own age who was the first person in Malawi to declare publicly his positive status. They married in a huge white wedding in the capital attended by their grown-up children, government ministers and senior clergymen. It was a huge celebration for people living with Aids. Helen Mhone founded an Aids organisation in Botswana three years ago to spread education and help the victims and their families. It began in a Portakabin in the main hospital in the capital, Gaborone. Now it has centres throughout the country. “But people are still hiding from Aids,” she says. “We know we have thousands of HIV-positive people, but fewer than ten are open about it.”
The two biggest challenges are how to stop the spread of Aids and how to prevent the social exclusion of people who are HIV-positive. Both are the result of the taboo about sex, Aids and death. Men in particular refuse to accept that Aids exists, that it kills and that it is spread by sex. In remote northern Swaziland, where the infection rate may be as high as 40 per cent, hundreds are already dying. Yet Paul Bhembe, headmaster of Ekuphakameni secondary school, told me that Aids is not a problem. “We don’t know why these people are dying, but it is not because of Aids, not in this area. It is not a problem here.” There was, he said, no programme for Aids education in the school; the timetable was already full. Aids education is “something from outside, something imposed on us”. When I pressed him, he admitted he and his teachers are too embarrassed to talk to students about Aids and sex. “It is part of the way we have been brought up. Talking about things that are not talked about and breaking out of the inhibitions is difficult. Not even parents talk to their kids about it.”
Combating this attitude and making sure that headmasters such as Paul Bhembe do not exclude children whose parents have died of Aids is one the chief campaigns of women like Helen Mhone and Siphiwe Hlophe. These small battles are becoming part of a war on the traditional relationship between men and women in Africa. In most of Africa, women are still subservient to men. Women are expected to be faithful in marriage, men are not. Aids deaths are exposing the hypocrisy of such mores both in westernised urban societies and, more shockingly, in more traditional rural ones. Other evils barely whispered before are also now being forced into the open by Aids fatalities. Sexual violence has been found to be commonplace. Children orphaned by Aids are often the victims of sexual abuse by uncles or guardians who adopt them.
One reason why women may be more motivated to lead the fight against Aids is that they are more vulnerable to the disease and its effects. Women are more likely than men to contract HIV from sex. They also have responsibility for bringing up children and keeping the family going, but they are economically dependent on men. I found a shocking, repetitive pattern: when a couple discover they are HIV-positive, the man leaves and finds another partner. The woman and children are abandoned. It was rare to find a man looking after his sick wife but common to find women nursing sick husbands.
The trauma of discovering they are HIV-positive often makes women lose their fear of – and their traditional respect for – men. Their lives now have an extraordinary intensity, helping others faced with the same personal crisis and speaking with authority about stopping the spread of Aids. Their message is that if women want to avoid Aids they must take responsibility for their own bodies. That means a fundamental revolution in relationships between men and women in Africa, a change as far-reaching as the Aids pandemic itself.
The most inspiring and unexpected tale came from Helen Mhone’s deputy in her organisation, a bright, striking 28-year-old called Onnie Moyo. She was working for a furniture company in Gaborone when she fell ill. “I had non-stop diarrhoea, like you have never known it – all night and all day. The director [of the company] was very kind and suggested I should know my HIV status. I had not thought of it until then. I was too afraid.”
Moyo went to visit a friend who was dying of Aids. “She had been very heavy, but now she was very thin. She had messed herself, she was dirty, so I cleaned her up, washed her and changed the sheets. I said to myself: that could be me tomorrow.”
So she went for a test. “When I went to get the results the doctor was holding them up and I could see through the paper. I could see that I was positive. My CD4 count [the level of cells that control the body’s immune system] was 200 [it should be above 500] and the viral load was 64,000. I was very thin and I could not retain food. But something told me I was going to fight. I started looking at the books and talking to people. I now know what to eat. I came to realise that I am HIV-positive and I have to live with that. I have to live with it as a friend. If you fight it you will lose.”
Soon afterwards, an old boyfriend, Edison, started calling. To make him back off, she told him she was HIV-positive. But Edison had anticipated that. “He said, ‘Yes, I know. Now will you marry me?'”
I asked Edison why. “Because I love her,” he replied without hesitation. Edison has been tested, but is negative. They want to have children but, as Onnie explains: “If you want a baby there is a lot to weigh up. My duty is to make sure he does not get infected by me. Also I could die and leave an orphan, or I could infect the baby. But we have decided to try.” They married on 10 August.