MABALANE’S HOME IS that of a very poor man. A flat, barren square of ground enclosed by a waist-high fence, two stocky, one-room structures at each end. One is his house, he tells us, the other his workshop. We are not in a village, but on empty land along a busy district road. The sparseness and the sound of the traffic lend the place a feeling of forlornness.
Mabalane’s wife is sitting on her doorstep and nods at us silently. I smile at her momentarily, but am distracted by the presence of two dogs. One is a very young pup, perhaps six weeks old. She is tethered to a post outside the workshop; she strains at the end of her rope in an attempt to join us. The other is skeletal, and barely conscious, and lies on his side breathing heavily. As we get closer it is apparent that his head is desperately swollen, as if a tennis ball has been inserted under the skin on his forehead.
He opens an eye at the sound of our footfalls: he is blind, his iris hidden somewhere behind his eye socket, his cornea a milky white.
“He was shot some weeks back,” Mabalane says, crouching over his animal. “He is going to die any day from now.”
He turns his back on the dog, searches the ground, and picks three herbs. He hands one to each of us, and asks us to chew it and then spit it out. An herbalist’s working space must not be polluted by the presence of people who have come from a funeral; the herb cleanses us of the recently dead.
The workshop we enter is dark and windowless. On the floor in the center of the room, several dozen bottles are piled haphazardly: half-pints, one-liter cold drink bottles, beer bottles. Some are filled to the brim with herbs, others are almost empty. Herbs are scattered all over the floor, from one corner of the room to the other. Among the bottles is a well-polished turtle shell.
“This man should be a sangoma,” Sizwe murmurs quietly. “This is a sangoma’s place.”
The remains of two creatures hang from the ceiling on low hooks. One is the coat of a genet. The other is an owl, its broad wings stretched wide, its torso a rotting and mutilated cavern.
“That owl,” I say, “why do you keep it there?”
“If I kept it on the floor the rats would eat it,” he replies.
“Yes,” I say, “but what is its function here?”
“When somebody wants to bewitch this place,” he replies, “they send an owl. I make a fire in which a piece of this owl is burnt. The owl that has been sent to bewitch me smells the fire and knows not to come here.”
He gets down on his haunches, chooses three bottles, pours out a generous portion of herbs from each, mixes them together, and empties the cocktail into a supermarket bag. He rolls the bag up tightly and throws it across the room into Sizwe’s lap. Sizwe reaches for his wallet in his front pocket, finds two hundred-rand notes, and puts them down next to him on the floor.
“I notice that you use three herbs for AIDS,” I say. “It is just like the doctors. ARV therapy uses three kinds of drugs.”
“Yes,” he says. “One herb is for TB, another is for diarrhea, and the third is for headaches. When you mix them together it cures AIDS.”
“Do you have to travel far into the forest for these herbs?” I ask.
“No. They grow right here in my yard.”
We leave the workshop and he accompanies us to our car.
“A man from East London came here a while ago,” Mabalane tells us unsolicited as we are leaving. “His name is Mr. Simgo. He took a sample of my medicine to test in a laboratory in Bisho. I am not sure when he is coming back. But I am not worried about his test. Whatever the results, I know that my medicine cures AIDS.”
WE RETURN TO the funeral, pick up Sizwe’s mother and two other people who are going to Ithanga, and drive home. By the time we are alone together again, it is almost dark. We are standing outside Sizwe’s shop.
“What do you think of these herbs?” I ask.
He stares at the ground and does not reply for some time. “I’m not sure,” he says finally. “If it does cure AIDS, why do more people not know of it? Even at the funeral, where the people know Mabalane well, nobody had heard of it. But who knows? And what is there to lose?”
“The herbs are for Thandeka?”
“The main problem is her boyfriend,” he says. “Maybe these herbs will cure her and she will be reinfected by him. And then we will not know whether it has worked. Maybe what I must do is, I must visit the boyfriend and instruct him to go to Mabalane to buy two liters of medicine. Then I will sit Thandeka down, give her these herbs, and tell her not to have sex with her boyfriend for two weeks. Then I will take her to the clinic to test again.”
“The discussion with the boyfriend will be difficult,” I say. “He does not want to know about AIDS.”
“I have had some practice with people like that recently,” he says dryly. “And anyway, enough is enough. He is a sick man.”
He pats his pockets, checks his jacket, then looks up and smiles sheepishly.
“I have left the herbs in your car.”
I COUNT TWO weeks from the afternoon Sizwe bought the herbs from Mabalane, and mark the day in my diary. It comes and goes. Eight or nine days later, I get a call from Sizwe. I am at home in Johannesburg. He says he has phoned to say hello and to see if I am well.
He is awful on the telephone: stiff and proper and awkward. But I am too curious to wait another week until I see him.
“Did Thandeka and her boyfriend take the herbalist’s medicine?” I ask.
“They both took it.” A long pause. “When the two weeks were over, they went to the hospital. Both tested positive. They had their CD4 counts taken. Hers was 435. His was 402. They were told to come back in three months to have their blood taken again. And if either of them gets sick before the three months is up, then they must come back immediately.”
He relates these things to me blandly and without emotion. But I know that a heavy burden has lifted from his shoulders—to know that Thandeka’s CD4 count is 435, that there is still plenty of time, that she is not at death’s door, that there is now a protocol to follow.
“Mabalane did a very good job,” Sizwe says. “I am happy with him.”
“How so?”
“If it were not for the herbs, Thandeka’s boyfriend would never have gone to test. Perhaps even Thandeka herself would have done nothing until she was ill or dead. I am very happy with Mabalane. I must make a special trip to thank him.”
MUCH LATER, PERHAPS as long as nine months, Sizwe and I find ourselves driving past Mabalane’s place. Neither of us has spoken of him in a long time. I nod in the direction of his house.
“Have you seen your cousin lately?” I ask.
He laughs. Puzzled, I laugh back.
“What’s funny about Mabalane?” he asks.
“I was responding to your laughter,” I say. “It was you who laughed at the mention of him.”
A long pause. “When you wrote about Mabalane in your book,” he says, “why did you say that the fence around his property was knee-high?”
“I don’t remember. Did I say it was knee-high? Is it knee-high?”
“It is about the height of the stomach. You exaggerated. You wanted to show that the man’s place was fucked up. What fool wastes his time and money building a knee-high fence? Anything can get over it, even a small dog.”
He had said nothing of this when he first read the chapter about Mabalane. That was some six weeks ago. It was one of those thoughts, I guess, that one holds back. Now he is telling me he has seen his world through my eyes, and what he saw was people with useless fences around their gardens and useless bottles of herbs in their rooms.
“Where else have I exaggerated to show that things are fucked up?” I ask.
He shrugs. “I’d have to go back and look.”
I recall his defensiveness on the phone when I asked him whether Mabalane’s cure had worked, and I think I see what he is protesting against when he shields his cousin from me. He is protesting against a collective humiliation. Black people have gotten sick in droves and
line up outside the clinic to get the medicine the white doctor has brought. It is humiliating. Before the gaze of their community they are outed as the bearers of a disgraceful disease; they must sit in support groups run by fiery young women and for the rest of their lives they must swallow ghastly pills that serve only to remind them that they are sick and that each cough or bout of diarrhea could lead to death.
He wants very much for an end to this, and for the end to be delivered by a dose of Mpondo medicine; a gift from the ancestors that heals one now and forever and puts an end to the lines outside the clinic and the counselors in the school hall.
I have rubbed his face in it. I went to Mabalane’s place, and what I saw was a knee-high fence.
Nombulelo
The person Sizwe has approached to become Ithanga’s Kate Marrandi is a single woman in her mid-fifties named Nombulelo. He chose her because she was once trained as a field-worker by an orphan support organization that is now defunct.
“The work is not very different,” he says. “Maybe it will not take the clinic so long to retrain her, and she can start work immediately.”
We visit the nurse in charge of the local clinic, and she agrees that Ithanga does indeed desperately require its own dedicated community health worker. If she is embarrassed that it has taken this long to attend to a village in her jurisdiction, she does not show it; with easy authority, she tells us to send Nombulelo to her.
Nombulelo’s home stands at the very bottom of Ithanga’s narrow valley basin, and the path from Sizwe’s place to hers is so steep and slippery that I spend much of the journey walking crablike, digging the sides of my shoes into the mud.
“How well do you know Nombulelo?” I ask. “Will she be as good as Kate?”
“She can read and write as well as Kate,” he replies. “So she will be good. The thing that can make her not so effective as Kate is that she grew up in Ithanga. Her whole life she has competed over men in this village. It will make her work very difficult.”
“Is she married?”
“She used to be married. She separated from her husband many years ago. Over the years she has been the girlfriend to several men in this village.”
“How has she supported herself?”
“She has a big homestead like a man. She has made money selling oysters and crayfish to the hotels on the sea. She is a very clever woman. She has learned how to save money. Much cleverer than most of the men of her generation: they throw their money at women and at beer and they and their families die poor. Her son, he has gone off to study. Me, I couldn’t finish matric because…”
His sentence trails off, and he shouts a greeting to a man a hundred yards below us.
Described by Sizwe’s tongue, she is a giddy combination: an unattached woman who builds a home as a man ought to. He is surely right: she must be both the best and the worst person to be drawing the epidemic into the open. If Sizwe’s spaza shop courts such envy, then what of a woman who invented her own business and has slept with husbands of her fellow villagers to boot? I imagine she must marshal admiration and resentment in equal measure, that the idea of her conjures both promise and scandal.
She is waiting for us. She sees us from some distance away, locks her front door, and joins us on the path. She is small-boned and thin. She greets me quietly, puts her head down, and does not speak. She is shy. Throughout the walk out of Ithanga, I do not get a proper look at her face.
In the car on the way to the clinic, I ask her how she will begin her work, and she says her first task will be to start a support group in Ithanga.
“What is your strategy?” I ask. “People are so scared here for their neighbors to know they are positive. How will you get them to come together in broad daylight and sit together in a group?”
“I will attend every funeral every weekend, and I will speak to every mourner,” she says. “I am not HIV-positive, but I will tell people that I am. That will give them the confidence to come to me. They will trust me if they think I am HIV-positive.”
“You are sure that’s wise?”
“My work will fail if they think I am negative,” she says authoritatively. “People are too disgraced to confide in people who are negative. The people who are negative talk about them at funerals and at functions. They whisper about them. How will they confide in me if I am someone who might whisper about them?”
“Would your position not be much stronger,” I ask, “if you could show them both that you are HIV-negative and that you embrace them? Isn’t an important task to break the divide between the positive and the negative?”
“It will not work,” she says. “They need to have trust in me.”
Listening to Nombulelo, I wonder where the epidemic’s peculiar twilight ends. For Sizwe is here in the car, a fellow villager who knows everyone she knows; might he not one day, in the course of casual conversation, tell drinkers at his spaza shop that the rich, single woman in the valley is only pretending to be HIV-positive? Among the things stored in the village’s stock of common knowledge—the same stock in which the ARV girls’ regular taxi trips to the clinic are stored—will be the notion that Nombulelo pretends to be positive in order to tend to those who pretend to be negative.
“You are not married,” I say. “Does that affect the way you do your work?”
“A married woman could not do this work,” she replies crisply. “She would not have the freedom. Her husband wants her to cook, to do this and that, to wash his clothes. Doing this job properly means being called out at any time. You must have love and commitment, and you must be unmarried.”
WE PARK OUTSIDE the clinic. Nombulelo disappears into the gloom of the building’s interior to her appointment with the nurse in charge; Sizwe and I settle under a tree a few paces from our car.
“What do you think of the fact that she is going to lie about her status?” I ask him.
He looks away, a cold, disinterested expression on his face.
“All the counselors do that,” he says. “Even the ones who came to Ithanga that day last year to test the people at the school. They tell you they are HIV-positive and on drugs and alive and well, in order to charm you into saying you are HIV-positive.”
“How do you know they are lying?” I ask.
He laughs hollowly and says nothing.
“Seriously,” I say. “How do you know?”
“Some are HIV-positive. Some are not. The ones who lie, what they are doing is wrong.”
Several recent events lie in the background to our discussion, shaping its meaning. Hermann Reuter’s four-year stay in Lusikisiki is to end soon; Médecins Sans Frontières will be handing the treatment program over to the Eastern Cape Department of Health. There is a great deal of apprehensiveness among the counselors, pharmacists, and community health workers Hermann trained. They worry about the future of treatment in Lusikisiki in the absence of its pioneer.
“These ones who charm the people by saying they are HIV-positive,” Sizwe says, “if they are worried about Dr. Hermann leaving it is because they are worried about their jobs. But I think their jobs will be okay. The people have been shouting at Thabo Mbeki, for letting the people die. So, maybe, if they shout loud enough, the government will now employ these ones from MSF to stop the people from dying.”
Had I closed my eyes while he was talking, I would have sworn that his comments were soaked in sarcasm. But the expression on his face suggests that what he means is unclear. Both to me, and to him. Perhaps the movement Hermann built here consists merely of people in search of salaries and positions; they beguile the ill into humiliating themselves in order to feather their own nests. Perhaps they are nonetheless saving from death the people they have tricked. Perhaps both of these things are true. Perhaps neither is true.
When he chose to accompany me to the clinics he was utterly uncertain about ARV medicine. His journey was experimental. Now that our travels are almost over, he has made decisions of much consequence: he has taken Jake’s surviving b
rother to get antiretroviral treatment, he has coaxed Thandeka and her boyfriend into getting their CD4 counts taken, and he has found a Kate Marrandi for his village. And yet all these decisions are provisional. If he wakes up tomorrow morning to discover that he was wrong—that the drugs will leave with Hermann Reuter, that people quickly develop resistance to them and die, that those who brought them to Lusikisiki always knew this to be a ruse—he will not be surprised.
“These are not easy times,” he says. “In my parents’ and my grandparents’ day, they got lots of sexually transmitted infections, but they did not die. Those diseases were made by people and AIDS is made by people, but in those days, sexual diseases did not kill.”
“You know that AIDS is made by people?”
“Look over there,” he says, pointing over my shoulder. I turn around. The front of a wide forest faces us from the middle distance. It climbs a hill and disappears into a valley. From somewhere beyond the horizon, a scrawny trail of smoke twists into the air.
“We have a saying in Xhosa,” he continues. “When you see smoke like that in the air, it means there is someone underneath, at the bottom. Some people have been lighting a fire. If you see smoke in the air and you think it is just there, it just happens to be there, you are not thinking straight. It is not just there in the sky. There are people at the bottom. That is where it has come from.”
He pauses, but he is not finished.
“Somebody must have made AIDS. Maybe it went out of control. Maybe this is not what they wanted. But somebody made it.”
“Fires start for many different reasons,” I say.
“Tell me. You have never told me your explanation of where AIDS comes from.”
I tell him of a virus called SIV that has been endemic in beasts of the central African jungles perhaps for centuries. I tell him that human beings entered these forests in large numbers for the first time during the last century, perhaps in the 1930s, that the virus was transferred and mutated into a form that could be spread from person to person. By the early 1980s, I tell him, there were cases of AIDS on every continent, but it is here in southern and eastern Africa that conditions permitted the virus to spread far and wide: weak governance and poor public health programs, the sorts of inequality that cause people to travel far both for work and for sex, the sheer accident of whether a male population is circumcised, a combination of poverty and tropical parasites that have made the bodies of many Africans more vulnerable to sexually transmitted infection than most. I tell him that this is the story I have accepted for the moment, that it comes from a reservoir of knowledge I have passively inherited rather than chosen, something that is just in the air around me, as witchcraft is in the air around him, that I myself have next to no expertise in these matters, and that the story is by no means adequate, that almost everything about it is provisional.
Sizwe's Test: A Young Man's Journey Through Africa's AIDS Epidemic Page 25
