As you may or may not know, there are currently about five million South Africans infected with HIV. That’s about 11 percent of the population. KwaZulu Natal, the province where I am living, has the highest instance of infection in the country. I have spent the last three months learning about HIV, studying it from both a medical and social point of view.
Nonetheless, I felt quite out of place and overwhelmed the other week when I began working in a public HIV clinic. For starters, clinics here are different from those in the United States. There are no appointments, so patients must wait in long lines for hours, holding their files and waiting for their turn to meet with the doctor. The sign on the door says that the average wait is about two hours, but it can be up to four. Hundreds of patients come through each day. Half of the doctors in the clinic do not speak Zulu, so they must either hope that the patient speaks English or find a nurse who can translate.
Since I spent three weeks at the clinic, by the end I felt quite comfortable. Still, each time a patient came in, I was slightly afraid that I might contract one of the additional infections he or she had (everyone had HIV, but most were afflicted by other infections). Like the man who had untreated syphilis. Or the man who the doctors guessed had multi-drug resistant tuberculosis. I was very glad that I was wearing a mask that day, though none of the doctors were, which was disconcerting.
Some of the interns asked me about HIV and sex education in the United States. I told them that I grew up in Washington, D.C., which at around three percent, has a high HIV rate compared to other parts of the United States. They stared at me, and said they wished that the prevalence of HIV were that low in South Africa.
I came to South Africa for many reasons, but one of the most important was to learn about HIV and anti-retroviral drugs (ARVs). ARVs are not a cure for HIV or AIDS, but they do help people with the virus to live longer and stay healthier. One of the interns at the hospital told me that, in his opinion, ARVs are just damage control. They are meant to prevent those with HIV from spreading the virus, not to actually help them. It’s a sad truth, especially in South Africa where so many people are infected and rely on the government to provide drugs for free. In order to qualify for the drugs, a person must have a cluster of differentiation four count (a measure of white blood cells) below 350. But if a person is at 400, there is nothing to do but wait until he or she gets sicker. One wonders how much good this policy is really doing.
Though this is a fairly depressing last column, my semester here has not made me depressed or pessimistic. Some days made me feel that way (like the day I spent in the pediatric HIV ward) but others made me excited and grateful and amazed. Parts of South Africa make me forget I am even abroad, and others make me want to cry. Overall, as corny as it sounds, I wouldn’t trade these past few months for anything. Even though I had to sign a waiver saying that I have a high risk of contracting several deadly illnesses, it’s been worth it.
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