Twenty Chickens for a Saddle

by Robyn Scott

  I wanted to clap, but the silence was paralysing.

  Such extremely racist views on the disease were unusual, though. For most whites in Botswana, AIDS was what it was: a complex humanitarian tragedy. Albeit a removed tragedy, generally experienced secondhand – a depressing story about an elderly maid, or a friend’s maid, with a dead child, or two dead children, who was now supporting all her grandchildren in a single-roomed house.

  “Keith, you must understand,” friends would say after recounting some desperate situation, “I do what I can to help Precious and all her grandchildren. But the problem is so enormous. What’s behind it? How can it be stopped?”

  Dad would give his opinion: the need for comprehensive awareness and prevention programmes; the need for drugs; the need to tackle superstitions.

  “Like what?”

  Getting the virus from having sex with a woman who has had a miscarriage, curing it by having sex with a virgin. “A lot of my patients in the villages don’t understand infectious diseases,” Dad explained to intrigued white audiences. “They think it’s something passed from one person to another, leaving the transmitter HIV-free.”

  The jangomoj, or traditional healers, many of whom encouraged this belief, maintained that HIV, like other STDs, had always been around. They also claimed they could diagnose HIV by throwing the bones. This problem was so widespread that the Ministry of Health invited a group of sangomas in for an experiment, which was to be reported in the local papers. The healers were given equal samples of HIV-positive and HIV-negative blood and asked to throw the bones. They were correct no more than 50 percent of the time – no better than chance.

  Still, this failed to discredit them in the minds of many people.

  “Surely not?”

  “Of course,” said Dad, “these are entrenched beliefs. You’re often dealing with rural, uneducated people who still believe that ancestors play a part in daily life. And who pay witch doctors to curse their enemies.”

  Occasionally, Dad’s explanations would affront ‘PC whites. “Surely all this stuff is just a white Western viewpoint…an uninformed stereotype of complex African cultural beliefs…an easy assumption of backwardness?”

  Dad hated political correctness almost as much as he hated the ‘AIDS has been sent by God’ argument. Mum said, “Political correctness is antithetical to your father’s nature.”

  I’d watch with bated breath.

  “Of course it’s a stereotype,” he’d retort furiously. “Of course not everyone thinks that. But there are lots who do, and you can’t just gloss over it because we don’t like to think we’re portraying blacks as less sophisticated. It’s a reality. A life-and-death reality. To be dealt with.”

  Where they did mix with Batswana, most white ‘expats’ mixed in businesses and the public sector, with educated urban Batswana. This sector of the population had a more Western outlook and often looked down on the rural villagers. The whites formed opinions accordingly. So in discussions with whites on Batswana beliefs, Dad usually had the last word: partly because he was so hard to argue with, but mostly because not many whites regularly came into contact with the rural, most traditional face of the country.

  Jean Kiekopf was one of our few expatriate friends who could tell Dad stories about Botswana that surprised him. As an English teacher with many rural pupils, and as a doctor with several rural practices, Jean and Dad were amongst a much smaller group exposed to a more traditional, witchcraft-and-ancestor-oriented approach to life.

  It was while wearing these hats that Dad and Jean had met – Jean in a state of some panic – soon after we’d arrived from New Zealand, and she had come out from England.

  Jean’s dog had just had puppies, and she’d gone home during lunch to watch them being born. Returning to her classroom, she explained excitedly to her class of sixteen-year-olds what had kept her. Her students listened in silence. Most looked appalled.

  “Did you put ash on your face before you watched?” asked a serious, very traditional boy.

  The same boy, Jean later discovered, went all the way to Zimbabwe for his preexam muti, because the sangomas there were more powerful.

  “No, of course not,” said Jean. “Why?”

  “You will go blind,” said the boy sombrely.

  Momentarily chilled by his earnest, sympathetic face, Jean smiled and continued her lesson. The next morning she awoke, barely able to see through puffy eyes. Her eyes watered, and her swollen eyelids almost obscured her eyeballs. She rang up Dr. Chothia, who had no appointments. “Try Dr. Scott,” she was told. “You’ll just have to queue.” So Jean went and sat in the packed waiting room at Dad’s clinic, peering out between slits and silently telling herself that she couldn’t possibly be going blind.

  “Allergy,” pronounced Dad. “I don’t think you’ll go blind. You’ll get over it in a day or two.”

  Jean took Dad’s prescription for the allergy. She didn’t go blind. But it did take her a week to see properly again, during which time she couldn’t go in to school. Even when she returned, her eyes were still red and sore. The class was unsurprised and unsympathetic. “I told you, Mma Kiekopf,” said the serious boy.

  Jean, her husband, Klaus, and her son, Luke, had later become good friends, and when we moved to the farm, they were regular visitors. On these weekends at the farm, she often took the opportunity to quiz Dad on medical facts about AIDS, which she was now incorporating into her English lessons.

  “Can you get it from kissing?”

  “Oral sex?”

  “Anal sex?”

  “Toilet seats?”

  “Touching sores?”

  “Sharing razors?”

  In one of its late but clever moves, the government had decided that information about HIV and AIDS must be enmeshed in education, and by the end of 1997 this was being taught as part of the syllabus in most subjects.

  Jean, who was a gifted and dedicated teacher, approached AIDS education with her usual energy. Determined to be as candid and open as possible, to be able to answer any question, she’d been relentless about becoming well informed. “Thought I knew it all,” she told us once, on a visit to the farm. “But it turns out, Keith, I have another question for you.”

  She had recently devoted a whole lesson to discussing HIV with a class of seventeen-year-old students. Towards the end, she’d opened it up to questions. “Please ask me about anything I haven’t covered,” she’d said. “Anything that might be worrying you. And if you’re too embarrassed to ask here,” she’d added, “just slip me a note under my door.” One of the boys had raised his hand. “Can you get it from having sex with a goat?”

  Some of Jean’s students had giggled at the questioner; from a few there’d been curious, expectant silence.

  Now, as she told us, Jean paused as everyone laughed.

  I said, “Sis.” I’d heard about people having sex with goats and donkeys before. And in Zimbabwe, when I said I was originally from New Zealand, boys would sometimes joke that that was where men on lonely farms ‘shagged sheep’. But being reminded of it was always startling.

  Jean had said uncertainly, “I don’t think so. As far as I know it’s a human virus.” The boy had raised his hand again. “Can you get it if you have sex with a goat after someone who has HIV has also had sex with the goat?” There’d been more giggles and scorn from his classmates. But still, silence from some.

  I said, recovering from my disgust, “That’s such a clever question.”

  “It was,” said Jean, “but I have to say I felt a bit out of my depth.”

  Blushing, Jean had cleared her throat. “I don’t think so,” she said. “But I’ll check and get back to you.”

  Afterwards, she’d questioned some of the Batswana teachers. “Yes, it sometimes happens,” they’d informed her, “in the bush at the cattle posts, where there are lots of men on their own.”

  Now Jean put the question to Dad.

  Dad said, “No, I’m pretty confident you woul
dn’t get it that way. Although I suppose it is technically possible if it happened very quickly.”

  This led to a discussion about how women are much more likely to catch it through sex than men. Because there’s more soft surface area – which might already be damaged through other infections or trauma – and because the virus gets to sit in a moist warm environment, whereas on the retracted penis the virus is quickly exposed to deadly air.

  “Which is really not fair, given that it’s usually men who don’t want to use condoms.”

  Then we had lunch.

  All of this – the gruesome, the curious, and the sometimes shocking – Dad discussed without flinching: matter-of-fact, sardonic, and unemotional as ever. But the worst part of AIDS, the daily reality of his clinics, he rarely mentioned. And about it, we never really asked. We knew enough from his face, which, when he returned from his clinics, was grimmer and more haggard than I’d ever known it.

  There was nothing really to discuss, nothing one could say to make it any better. Dad saw at least a hundred patients a day. By the late 1990s, more than half of them had obvious signs of AIDS. He gave them medicines to treat the opportunistic infections. And then he looked them in the eye, told them there was nothing else he could do, and sent them home to die.

  Fifty people a day.

  ∨ Twenty Chickens for a Saddle ∧

  Twenty-Six

  Elizabeth

  In 1997, two years after Mum had heard about Damien’s school-to-be on the radio, she listened to a programme that was to define the remainder of our family’s years in Botswana.

  The interview was with Professor Patrick Bouic, an immunol-ogist conducting a trial with a plant-derived immune supplement on HIV and AIDS. The newly released results from the more than one hundred patients were remarkable. Particularly in the early stage of HIV infection, the supplement appeared to dramatically slow – and in some cases halt – the progression of the disease.

  Mum told Dad, and Dad at once phoned Professor Bouic to discuss the results. Immediately afterwards, Dad phoned the company producing the supplement to place an order. A few weeks later, he began giving it to his AIDS patients.

  Away at school, I followed the story in outline and heard via Mum how excited Dad was about the results from his patients. But not until I returned for the holidays did I really understand what it meant for Dad. He talked about it endlessly. “They start getting hungry again. That’s what they all notice first…sometimes it takes just a few weeks. Then they put on weight…I know I’ve said it before, but I just cannot tell you how bloody nice it is to be able to finally give my patients something…”

  Dad had the old sparkle in his eye, the old excited edge in his voice. I was almost as excited by the effects on him as by the effects on his patients, which he repeatedly, elatedly, described. In a few months, this hope had renewed his interest in work in a way that nothing had since he’d decided to be a flying doctor all those years ago when we arrived in Botswana.

  For the first time ever, AIDS discussions hijacked the long evening walks and exquisite river paddles. The pristine hours once reserved for happy dreams of extrication from the clinics and ecosystem rehabilitation became a time when Mum and Dad spoke, endlessly, of something that they both believed could change the course of the epidemic in Botswana.

  “You see,” Dad said, striding out along the dusty path, “even if the government does get around to giving ARVs, you can’t give the drugs too early on in the disease process. These sterols and sterolins work best in the early stages. So they’re an ideal complementary treatment.”

  “And of course,” continued Mum, “it’s an immune booster, rather than directly attacking the virus. So you don’t have the risk of resistance if patients don’t comply.”

  Mum and Dad ostensibly talked to us – but really they talked to each other, batting ideas and plans back and forth, building momentum, like a long, elegant rally in a game of tennis.

  “And let me tell you,” said Dad, “compliance is going to be a hell of a problem. It’s bad enough with TB drugs, and they don’t make you feel crap like ARVs.”

  “And sterols and sterolins,” said Mum, “are jolly cheap. Fifty pula at cost. Which is what? The price of a few bags of mealie meal.”

  “The government could give it to the whole country for next to nothing – ”

  “Now Dad just needs to get out there and tell other doctors about it.”

  “There’s the inevitable scepticism, of course – ”

  “But,” said Mum, “the results will speak for themselves – ”

  A giant snort from the river interrupted her.

  Sitting on the new wooden deck on the Limpopo, our legs dangling over the edge, we peered through the last of the late dusk light towards the island opposite the channel. In the water beneath the bank, the dark humps of the three now irritated hippos were still just visible.

  “Poor chaps want to get out and graze,” whispered Mum. “We should leave them in peace. They’re a bit stuck here, after all.”

  Here was one of the last deep pools in the river. The rains had been poor, and the Limpopo had flowed late and stopped early. A year before, rains, water, and dams would have dominated our conversation. This evening, though, they were not even mentioned. Where once the beauty of the farm had been a retreat from the horrors of Dad’s work – a microcosm in which there were no hopeless problems – suddenly it was a place from which he was preparing to do battle with the biggest problem in the country.

  Mum said, as we packed up our bottles of fruit juice, “Anyway, if anyone can do this, can change things, your father can…”

  We set off back home in the near darkness, shining a flashlight on the road for snakes and casting it into the bush, following a rustle, to catch the gleaming, moving eyes of unidentified creatures. All the while, Mum and Dad kept talking, and walking beside them, listening, I felt light-headed with hope and pleasure. When Mum and Dad were like this, rallying against some great challenge, it seemed that no amount of differences between them would ever be enough to push them apart. And I felt no doubt that together, like this, they could change the world.

  Thrilled by the response among his patients, Dad visited the company producing the supplement when he next collected his medicines in Johannesburg. He returned home more excited than ever.

  The story of Moducare was just the sort of natural medicine triumph Dad and Mum loved. Behind it all was a South African businessman who’d originally commissioned research to assess the effects on cancer of the African potato, Hypoxis hemerocallidea, a well-known traditional remedy, when a relative with cancer had experienced a rapid improvement after taking the bulb. The initial laboratory research showed a significant immune-enhancing effect, and further studies narrowed this down to sterols and stero-lins, two plant fats that, unlike some of the other compounds in the bulb of the African potato, are non-toxic. Moducare, containing a combination of sterols and sterolins, was created and patented. Importantly, the new supplement did not share the immune-depressing effects of the long-term use of the African potato.

  So impressive were the immune-modulating effects that the company made a decision to focus instead on HIV. A clinical trial headed by Professor Bouic was initiated, and several years later, the first results seemed to bear out the hope that the formulation would indeed help HIV-ravaged immune systems.

  Dad had spoken excitedly of his anecdotal results, and the company asked him if he’d like to promote Moducare in Botswana. Dad had said yes at once and set about poring over hefty immunology textbooks, educating himself – and anyone else who wanted to listen – about the virus’s slow annihilation of the body’s defences. No detail was too much: if he was going to be travelling around the country to present the research to doctors, he wanted to be prepared for any question. He was determined to show that this had real science behind it, that it was not just a flaky hope fuelled by desperation for a solution to the insoluble.

  I was enthralled. For se
veral days, crouched beside him at the computer, I helped him tinker with his slides, and my head soon swam with pages of bright blobs and arrows representing the components and relationships of the immune system. They were fascinating simply as a lens into the body’s staggering sophistication; but when one considered the implications, the colourful pictures we created were truly gripping.

  At the heart lay the crucial CD4 lymphocyte cells, key coordinators of the body’s entire immune response. Dad explained how these cells, targeted by the HI virus, have their DNA hijacked to enable viral replication, and die in the process – their inexorable decline parallelling the relentless progression of the virus and the collapse of the immune system. When the concentration of these key indicators falls to about 20 percent of their normal blood levels, AIDS generally manifests. But taken before this threshold, the sterols and sterolins mix appeared to stop or dramatically slow the decline of CD4 cells, and thus the descent into full-blown AIDS.

  It was utterly compelling stuff. “How come everyone isn’t using it?”

  Dad said, “You can’t underestimate the resistance of the medical profession to natural solutions.”

  Mum said, “Everything doctors are taught primes them to immediately suspect non-drug treatments. Everyone’s forgotten good old Hippocrates. Let food be your medicine and – ”

  Dad interrupted. “And there is a hell of a lot of bollocks out there. Mum and I should know – we’ve tried most of it.”

  “But this works,” I said.

  “Well, it does appear to,” said Dad. “But it still needs a double-blind, placebo-controlled trial to be medically kosher. Unfortunately Prof Bouic’s trial was only an open-label trial with no placebo control. My own philosophy is that if something’s working and isn’t toxic and people are dying while you wait, you shouldn’t hang around for indisputable proof.”