Why Are HIV-AIDs So Prominent in South Africa - Essay Example

?Why is HIV-AIDs so prominent an issue in post-apartheid South Africa? Does religion offer solutions or exacerbate the problems? Introduction South Africa’s transition from apartheid to democracy was accompanied by a new constitution that held out hope for liberties and rights unheard of during apartheid. However, the transition from apartheid to democracy was largely obscured by a HIV/AIDS crisis.1 A large number of the South African population have adopted traditionalists policies aimed at managing sexuality and thus controlling the spread of AIDS. These practices and policies are embedded in religious and ritualistic practices and beliefs that involve circumcising boys and testing girls for virginity prior to marriage.2 This research study analyses the traditionalist religious approach to controlling the spread of AIDS in post-apartheid South Africa and argues that rather than offer solutions, traditionalist religion exacerbates the problems. This research study is therefore divided into three main parts. The first part of the paper provides details of the HIV/AIDS crisis in post-apartheid South Africa and analyses why HIV/AIDS has reached epidemic proportions in post-apartheid South Africa. The second part of this research study defines and analyses traditionalist religion in post-apartheid South Africa. The third part of this paper analyses the role of religion, particularly the traditionalist religion in countering the HIV/AIDS crisis in South Africa. HIV/AIDS in Post-Apartheid South Africa HIV/AIDS Data According to Horton, the HIV/AIDS crisis and its impact on social and economic development is “one of the most significant developments of” of post-apartheid South Africa.3 Approximately 2000 South Africans contract HIV/AIDS daily. According to the National Department of Health, there were 5.4 million South Africans testing positive for HIV in 2002 representing 12 per cent of the population. Further estimates maintain that a quarter of adults between the ages of 15 and 49 have HIV/AIDS. Approximately half a million South Africans have full blown AIDS and between 800 and 1,300 South Africans die as a result of AIDS daily. This represents 30 per cent of all deaths in South Africa and 40 per cent of deaths among adults between the ages of 15 and 49.4 According to Statistics South Africa, by 2004, the number of South Africans dying as a result of AIDS was 1.5 million. On average life expectancy in South African fell from 64 years of age in 1994 to 49 years of age in 2001.5 The United Nations reported that the number of children orphaned as a result of AIDS in South Africa by 2001 was 700,000. In 2002, the number of orphans as a result of AIDS was 120,000 and 150,000 in 2003.6 USAID reports that as of 2011, South Africa has the largest number of HIV/AIDS infections worldwide With the first reported case in 1982, the disease has reached epidemic proportions with 5.6 million South Africans living with either HIV or full blown AIDS. Moreover, South Africa’s infant and maternal mortality rate has increased steadily since the 1990s with AIDS largely attributed to the cause of infant and maternal mortality. AIDS is responsible for 42.5 per cent of maternal mortality and 35 per cent of infant mortality cases. While South Africa only represents 0.7 per cent of the global population, it is responsible for 28 per cent of the global HIV population.7 UNICEF’s report on HIV and AIDs in South Africa notes that “HIV infection rates” among adolescent girls are “on average five times higher” than “among boys”.8 According to UNICEF, “this is largely due to girls’ biological and social vulnerability”.9 For the most part women depend on men for economic support and usually do not have adequate education facilities and are therefore more prone to “poverty, sexual exploitation, coercion and rape” and are susceptible to work in the sex trade.10 Complicating matters for women, when they contract HIV or full blown AIDS they suffer heightened levels of gender discrimination. Women typically test positive for HIV during pre-natal examinations and as a result are typically labelled “spreaders” of the disease.11 Once women test positive for HIV, they are subjected to physical abuse, withdrawal of economic support and are often driven from their homes. Women in abusive or otherwise unhealthy relationships are especially vulnerable to HIV infections because they live under fear of more abuse, alienation or the withdrawal of economic support should they insist on safe sexual relations or abstain.12 Women in South Africa are particularly loathe to seek treatment in health services that are decidedly lacking adequate facilities for HIV/AIDS victims. Women’s reluctance to seek treatment stems from religious concepts that automatically assume that a woman who contracts HIV/AIDS is promiscuous. Moreover, religion commands that women take care of the sick and thus women are expected to care for family members who contract AIDS and women make-up a majority of the health care staff caring for AIDS patients.13 Women between the ages of 15 and 19 are more susceptible to rape and are particularly vulnerable to HIV infection particularly where the rape results in injury or bleeding in the genital areas. Moreover, women in this age group are frequently targeted for sexual relations because it is believed that these women will most likely not have HIV. In addition, rape by multiple assailants is said to be increasing in South Africa with the result that women are “at higher risk of HIV infection due to repeated exposure and increased injuries.”14 AIDS/HIV is obviously an unrelenting epidemic in South Africa. The disease has reached epidemic proportions as a result of the marginalization of women. It has been established that women have inadequate access to education and are largely dependent on men or the sex trade for economic sustenance. As a result women are reluctant to reveal or seek treatment for HIV/AIDS and are inclined to have unprotected sexual relations with abusive partners for fear of further abuse or withdrawal of economic support. In other words, women who contract HIV/AIDS are often forced by either physical abuse or economic want to conceal that they have HIV/AIDS or to refuse medical treatment. It therefore follows that women, by virtue of social and economic realities in South Africa are not only vulnerable to HIV/AIDS, but are prone to spread the disease via forced sexual relations. Why HIV/AIDS is a Prominent Issue in Post-Apartheid South Africa During apartheid, the Black identities were entirely simplified. Blacks were essentially culled together as a group and ruled from a White perspective with essentially a collective attitude that all Blacks were the same with no significant distinction between them. From the perspective of the Blacks it was the evil Whites against the victimized Blacks. However, with the end of apartheid, Black identity was no longer simply explained in terms of Blacks as a single indistinguishable group and Blacks against Whites.15 Zegeye and Harris explain that in post-apartheid South Africa it is no longer possible to speak of Black identity “without reference to such dimensions as class, gender, sexuality and ethnicity.”16 Black masculine identity has been explained in a way that attributes much of the responsibility for the HIV/AIDS epidemic in South Africa on men, particularly the youth. Pattman explains that young South African black men had become identified as “shock troops or foot soldiers in the struggle for political change” and in post-apartheid South Africa these identities “have become redundant.”17 Thus young Black men and black South African men in general have faced increasing “estrangement and uncertainties” in post-apartheid Africa.18 Complicating matters, the incidents of increased unemployment and the enlargement of women’s rights under the post-apartheid constitution have only created greater insecurities and uncertainties relative to masculine identities in South Africa. It has been theorized that increased incidents of sexual violence and taking on multiple partners have been one way of expressing these uncertainties and establishing masculine identities in post-apartheid South Africa. As Pattman observes: Young Black African men in Southern Africa have been particularly problematized in the context of the HIV/AIDS pandemic, with campaigns and literature especially addressing them as people with multiple partners and engaging in forms of sexual harassment and violence.19 Frahm-Arp explains the prominence of HIV/AIDS in post-apartheid Africa in a way that attributes the epidemic to both men and women. In Soweto, Rosebak and Sandton, Guateng there has been a rise in the “new hedonistic-material culture” which forms a part of the “new post-apartheid cultural revolution.”20 In the cultural revolution of post-apartheid South Africa, sex has become politicized to such an extent that “sexuality has become a symbolic expression of political and social freedom.”21 In other words, the transition from apartheid to democracy has challenged masculine and feminine identities. Males have been challenged by the liberalization initiatives that are poised to empower women and have been further challenged by an increase in unemployment. Males thus assert or express their sexuality in sexual violence and promiscuity. Women on the other hand have expressed their new found freedoms by choosing with whom and how often they want to have sexual relations. Thus women are both victims of and complicit in sexual behaviour that exposes them to the risk of contracting and/or spreading HIV/AIDS. Other problems in post-apartheid South Africa contributing to the HIV/AIDS crisis are attributed to a lack of “political will”.22 Although Nelson Mandela’s post-Apartheid government injected funds into an AIDS Plan, implementing the AIDS Plan has been entirely problematic and has been described as bereft of “progress” and undermined by a “breakdown of trust and co-operation, both within government and between government and non-governmental organizations”.23 Under President Thabo Mbeki from 1999-2000, a political culture of “denial” emerged.24 President Mbeki represented AIDS as somewhat “harmless” and took the position that much of the alarm associated with AIDS is a campaign by pharmacists seeking to increase the sale of drugs aimed at treating the disease.25 Mbeki and his Health Minister went so far as to state that the symptoms of AIDS “are caused by malnutrition and even by antiretroviral therapy itself”.26 When political leaders challenge the credibility of science it creates a culture in which the public is either denied or influenced to benefit from the knowledge and information that informs behaviour calculated to reduce the risk of contracting or spreading HIV/AIDS. In this regard, the South African government indirectly propagated a conspiracy theory relative to the scientific realities of AIDS and as such has become an active agent in the perpetuation of unsafe sexual behaviour in post-apartheid South Africa. Traditionalist Religion Traditionalists in South Africa attempt to create consistency in terms of belief and practices between “the living and the living dead, or the ancestors”.27 Traditional religion in Africa generally is not “an institutionalised religion” and there are no “priests, cult or doctrine”.28 As Denis states, the goals of African Traditionalist religion are: To develop a relationship of trust with the ancestors of the clan or tribe to prevent misfortune, accidents or disease which threaten to occur if the ancestors do not protect their descendants. For this reason, it is practised in the home under the aegis of the head of the household.29 During apartheid, traditional religion was popular throughout South Africa, but it was practiced secretly. This is to be expected since the European presence and governance in South Africa reflected the Western perception that traditional religion in Africa was based on superstition rather than religious conscience and was essentially atheism. Western perceptions also tend to view African traditionalist religion as a form of witchcraft.30 According to Ashforth, traditional religious practices have significantly escalated since apartheid ended. The escalation in traditional religious practices corresponds with an increase in HIV/AIDS seeking spiritual healing.31 Denis reports that 70% of all South Africans requiring medical treatment turn to traditionalists for spiritual healing.32 Medical doctors have expressed concerns about this practice since traditionalist healing has not been validated by science.33 Virginity testing which was originally intended to test the availability of a young girl for marriage for a dower had been phased out for the most part. However, with the HIV/AIDS crisis in South Africa, virginity testing was reintroduced particularly in KwaZulu-Natal and the Eastern Cape provinces. As Denis explains: Collective ceremonies for virginity testing, accompanied by songs and traditional dancing, are organized at regular intervals in public places, community halls, schools or public parks in both urban and rural areas.34 Those in favour of virginity testing argue that it plays a significant role in the reducing the incidents of HIV/AIDS contraction and transmission since it puts pressure on young girls to abstain from sexual activities.35 However, virginity testing can be entirely counterproductive. As previously noted young women are specifically targeted by men for sexual relations because it is believed that they are virgins and thus not infected by HIV/AIDS. The public nature of virginity testing readily identifies virgins and perhaps inadvertently functions as a means of marketing young women for sex. In this regard, traditional religion in South Africa does not offer a solution to the HIV/AIDS epidemic but rather exacerbates it. Human rights groups have made a significant argument demonstrating how religion in terms of virginity testing exacerbates the HIV/AIDS epidemic in South Africa. Human rights groups have characterized virginity as “sexist, humiliating and dangerous”.36 Virginity testing is entirely gender biased as it emphasizes the conduct of girls and attributes the spread of AIDS to girls. Meanwhile, virginity testing completely absolves men in terms of the transmission of AIDS and thus does nothing to alter their behaviour and their roles in the spread of the disease.37 Young women who fail a virginity test are likewise identified in these public testing rituals. Even when the hymen is absent as a result of a natural event or rape, these women are immediately labelled promiscuous or prostitutes and as such are exposed to sexual abuse.38 The treatment of women as second class citizens is not unique to the African traditionalist religion. For example, the Methodist Church of South Africa also discriminates against women, largely excluding women from official positions in the church.39 For the most part traditionalist religion in South Africa have viewed HIV/AIDS as a longstanding and recurring theme in their on-going struggles over the years. South Africa and Africa in general have suffered significant bouts of poverty, exploitation, disease and all manner of hardships in both colonial and post-colonial times. Thus as Becker and Geissler inform: The encounter between religious practice and AIDS, then, is part of Africans’ long-standing struggle with adversity, assault and domination.40 Therefore, spiritual healing is nothing new for South Africans. It represents a long process involving euphoria and re-examining codes of conducts emanating from spiritual tenets. Thus traditional religious responses to AIDS are informed by firmly established ideologies and practices. For South Africans, “prophecy and possession have been involved in confronting colonial rule and living with it.”41 Steyn argues however, that traditional religion in South Africa may not be traditional in that it is vastly similar to New Age theories of religion. Like New Age, traditional religion promotes conservation of nature and assimilates life with astrology and “extraterestrial life”.42 In this regard, traditional religion in South Africa offers an alternative approach to dealing with the problem of HIV/AIDS. It provides South Africans with a home-grown approach to the AIDS epidemic and allows South Africans to liberate themselves from the colonial and foreign dominance that drove their own belief systems underground. Traditional religion in South Africa therefore emerges as a symptom of South African liberalization. Free to establish their own identities, South Africans embraced their past and resurrected it in post-modern conditions that perhaps have an uneasy co-existence. For example the scientific realities of AIDS are not captured by traditional religion. Moreover, traditionalist religious beliefs that target the behaviour of women as the primary carriers and spreaders of the disease does not represent the kind of realistic intervention necessary for changing risky sexual behaviour. Traditional religion is not alone in terms of adequately addressing the problem of HIV/AIDS in South Africa. It would appear that all religions play a decisive role in the intervention strategies that essentially focus on demonizing and burdening women with the responsibility for preventing and reducing the risk of HIV/AIDS. It would appear that there is consensus that men are exonerated. The Role of Religion in Countering HIV/AIDS in South Africa Thus far it has been established that traditionalist religion takes an approach to solving the HIV/AIDS epidemic in South Africa by attempting to ensure that women act responsibly. This goal is evidenced by the public virginity testing rituals. In other words virginity testing is a manifestation of the notion that should women abstain from sexual contact until they are married, the spread of HIV/AIDS would be reduced, if not, eliminated altogether. This approach to countering the spread of HIV/AIDS ignores the fact that males are also a part of the problem. Moreover, it not only exaggerates the role of women in the spread of HIV/AIDs but also places an onerous burden on women for preventing the spread of HIV/AIDS and at the same time denies women a corresponding voice in society or in the religion. Fuller argues that religion in Africa generally takes an erroneous approach to stimulating change for the elimination of AIDS. In this regard it is necessary to: Examine how African women experience AIDS. Intervention measures targeted toward women must consider that their vulnerability may be due less to the risks they take in their individual sexual behaviour than to the prevailing sociocultural context in which they live.43 Moreover, it has been argued that in many African states, culturally and religiously constructed gender roles have created the greatest obstacles to programmes designed to reduce or to eliminate the spread of HIV/AIDS. These programmes have failed to motivate or promote men’s “behavioural change.”44 As we have seen, traditional religions promote behavioural changes in women by virtue of the public virginity testing. Traditional religion and religion generally tends to support a patriarchal society which does nothing to encourage men to change their behaviour and attitudes toward women. Masculinity in South Africa is particularly problematic relative to promoting change conducive to preventing the spread of HIV/AIDS. A study conducted among mine labourers in South Africa revealed that masculinity was defined by having several sexual partners, engaging in risky behaviour, satisfying physical desires and having multiple children.45 Another study found that using condoms is perceived as wholly inconsistent with notions of masculinity in South Africa.46 It therefore follows that masculine identities in South Africa encourage men to have multiple sexual partners, have as many children as possible and to resist practicing safe sex. Each of these traits either separately or together increases the risks of contracting or spreading HIV/AIDS.47 Nevertheless religion’s emphasis on male dominance and in particular traditional religious efforts to counter the HIV/AIDS epidemic insist on placing the burden on women. Religious views in South Africa, as elsewhere in the world is male centric in that it promotes bigotry and oppression for the perpetuation of a patriarchal order. The Christian religion is noted for its systematic support of oppressive social norms and practices. For instance the idea of a patriarchal familial and societal order is not only supported by traditionalist religions but other religions in South Africa as well. Religious support for these beliefs and practices alienates homosexuals, lesbians and women. Christianity at least could be put to more productive use in terms of the fight against AIDS/HIV.48 There are sufficient tenets in the Christian bible that promotes equality among mankind and generally “provides the church with the means to proclaim God’s emancipatory love.”49 Religion generally has been instrumental in the provision of care and support for those affected by HIV/AIDS. The assistance of religious organizations has been buttressed by foreign government aid via “Faith-Based Organizations”.50 In this regard, religion can play a positive role in helping HIV/AIDS victims fight the virus. However, the role of religion in preventing the spread of HIV/AIDS is questionable at best. ` Religion in general creates and perpetuates an ideology that either associates HIV/AIDS with either sinful behaviour or as a spiritual curse that is deserved. Essentially, the number of young unwed persons inflicted with HIV/AIDS indicates to religiously oriented South Africans that the individuals have practiced premarital sexual relations which is forbidden by a majority, if not all religions. Thus the ensuing disease is perceived as a well-deserved curse or punishment from God or the gods.51 It would therefore appear that despite the promise of religion to mediate between harmful attitudes that alienate victims of HIV/AIDS that perpetuate the problems of AIDS and the nurturing and curative potential of religion, religion has become complicit in the harmful attitudes relative to HIV/AIDS victims and the spread of the disease. Thus it can be argued that although religion can play a significant role in changing behaviour calculated to reduce the risk of the spread of AIDS, it has instead exacerbated the problem by fuelling harmful attitudes and practices. Conclusion This research study reveals that post-apartheid South Africa has encountered significant obstacles toward peace and prosperity in its transition from apartheid to democracy. With the spread of HIV/AIDS to epidemic proportions South Africans are confronting socio-economic problems associated with the social and economic cost of treating, preventing and facing disease and dying. This research study reveals that HIV/AIDS is an important issue in post-apartheid South Africa for a number of reasons. First and perhaps foremost, HIV/AIDS is a significant issue in South Africa because it is threatening the lives of a large portion of the young population. Secondly, HIV/AIDS has reached crisis levels since the end of apartheid and shows no signs of reversal any time soon. The reality is that instead of focusing all resources on moving forward and transitioning to democracy, post-apartheid South Africa is distracted by the destructive forces of HIV/AIDS. This research study also found that despite the potential for religion to intervene in efforts to eradicate the threat of HIV/AIDS in South Africa, religion has only exacerbated the efforts. Rather than approach the problem holistically, by altering attitudes and behaviour of men who in the assertion of post-apartheid masculine identities have engaged in behaviour that has put both men and women at a heightened risk of contracting and spreading HIV/AIDS. Religion has played a decisive role in the perpetuation of attitudes that erroneously place responsibility for spreading and preventing the spread of AIDS on women. 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