Mandisa Kalako-Williams, secretary general, South Africa Red Cross Society
The 2008 World Disasters Report makes a bold statement, one that has been feared and dodged by most. It argues that HIV and AIDS is a disaster – at the household, community and in some instances, the country level.
The Report asks us to look at key phrases in the standard definition of a disaster: “sudden or slow onset” - “beyond the coping capacity of a community” – “the need for external support and intervention.” This is what we face; a situation where the average home and family are not coping, be it from a lack of resources, poor access to information, health facilities, anti retroviral treatment, and in most cases, a simple ear to listen with empathy, as the affected person shares their fear, their dreams and even the woes caused by discrimination and rejection.
This is indeed, a disaster by anyone’s definition, and in this country, has the potential to destroy every developmental gain made in the process of democratising South Africa. We need to imagine what will happen to the economy of this country, when a large number of active young men and women fall sick, are unable to produce food, to earn their wages and can no longer participate in sports.
Beyond the harrowing figures and statistics, one has to only go to some of our cemeteries, to witness the number of new graves, to see the funerals being held even during the week to see proof of the emotional, psychological and economic trauma inflicted on those remaining behind.
In my small village, I know of one widow who has buried three of her children. She is now nursing an HIV positive orphaned grandchild, and has two of her remaining daughters going in and out of hospital. She has become lonely, walks as though in a dream, and one wonders if all the kindness of some of her neighbours can take away the pain inflicted by those who snicker and gossip about her plight behind her back.
Yes stigma and discrimination are as responsible for this disaster as the actual virus itself. The reactions of family, friends and the authorities have a bearing on how people affected by the virus view themselves and the world around them.
In yet another small town in the Eastern Cape, an HIV positive mother has been known to wander about aimlessly and totally distanced from reality. The township has branded her as crazy, sick and infected – not to be allowed to mix with others. Her 18 year old son, previously an achiever at school, has become violent, moody and totally withdrawn. Angry, perhaps at his mother, the community, the fellow students who ridicule him, sometimes to his face, about whose child he is. He probably hates and curses the virus, for the changes it has forced upon his family.
If we multiply these examples by the number of people exposed to, and already made vulnerable by the pandemic, then we know we are in the middle of a disaster.
But what then would be the effect of a natural or man made disaster on these communities? When already limited health services are disrupted, the ability to reach relief distribution points is curtailed by a weak and sick body. In some disasters people would only escape with the clothes on their backs – no documents, no food, no medicines, and therefore a longer and more painful process to access medication.
The Report, rather than painting a picture of total doom, has some advice on how we, collectively, can make a difference at the individual, community, national and global levels. It shows the positive impact of community-based health care, as practised in the countries of Southern Africa, and further advocates for integration of HIV and AIDS into our disaster management activities.
It calls for us to be involved in identifying, managing and minimising the risks of this disaster, through prevention, education, care and support at all levels. It cautions against the tunnel-vision provision of financial resources, which tend to apply a “one size fits all” approach to the fight against the spread of HIV and AIDS.
Today we should applaud, thank and encourage all the health workers, the community-based carers, social workers and doctors, who spend all their time next to a patient – a mother who has lost a child or an orphaned boy or girl – and offer them comfort and hope. The real impact of this disaster is felt first hand by those who have to live with it, who go to sleep and wake up in the same or worse situation.
We can all be humbled by the knowledge that those carers represent us, they are the real face of compassion, the real managers of this disaster of HIV and AIDS. Through them, we see the power of humanity, as they draw us closer to them, to their work, saying “together we can.”
This is an edited version of a speech delivered by Ms Kalako-Williams at the Southern African launch of the 2008 World Disasters Report in Johannesburg