Photo: IRIN  | | Slaughtering a goat as part of a "cleansing" ritual |
Swaziland is a harsh place to be for anyone touched by the AIDS epidemic.
The country has no constitution, let alone laws outlawing discrimination against HIV-positive people. Widespread conservatism results in HIV-positive people being banished from their own homes. And it remains taboo for someone to declare publicly that they are HIV positive.
"Rather than face the crisis head-on, AIDS is still spoken of in hushed tones, and those of us who are HIV positive are blamed for being ill," veteran AIDS activist Hannie Dlamini told IRIN. Dlamini, the first Swazi to publicly acknowledge that he was HIV positive, is a founding member of the Swaziland AIDS Support Organisation.
Figures soon to be released by Swaziland's Ministry of Health will show that 38 percent of the country's adult population is HIV-positive. The figure is up from the 34.5 percent recorded at the beginning of this year, and far above last year's official count of 22.5 percent.
"It's a vicious cycle," said AIDS counsellor Sipho Ndwandwe. "The more we are in denial about AIDS, the more people who should be cautious are reckless, and the disease spreads. Because people refuse to believe how widespread AIDS really is, they shun known AIDS sufferers, and treat them as isolated, dangerous individuals."
"I was chased away from my homestead," 32-year-old Winnie (not her real name) concurred. "My husband died of AIDS. He has two other wives, and we are all HIV positive. But he probably got HIV from one of his girlfriends. I got a blood test, and when his family learned I was positive, they exiled me from the farm. They blamed me for my husband's death. They said I would kill other people."
Winnie is seeking legal advice in a bid to claim a piece of her late husband's meager estate in order to support herself and her children. However, according to the Swaziland branch of Women in Law in Southern Africa (WLSA), complicated traditional inheritance rules ensure that most widows like Winnie are condemned to poverty.
Discrimination is also rife in the workplace, where employers have been known to dismiss HIV-positive workers.
"It was the head teacher of the school where I taught who I first told about my HIV," teacher Albertina Nyatsi, 28, recalled. "Two weeks later, he told me not to come back. He didn't use HIV as the excuse. He didn't give any reason. I went to the Ministry of Education. I was their employee, and not the employee of any particular school or head teacher. But they reassigned me to another school."
Meanwhile, Albertina Dube, a street vendor and former nanny, has first-hand experience of how doctor-patient confidentiality can be abused. "Five years after I learned I was HIV positive, I got sick," said Dube.
"My employer took me to his doctor. The doctor told my employer that I was HIV positive, and my employer took me off from work. He thought I'd die soon. He said, 'Now you won't be able to work hard, so it is better that you go and stay home.' That was unreasonable, because I had HIV for five years, and I was working without any problems."
Dube approached The AIDS Support Centre (TASC) in the commercial city of Manzini, and some TASC counselors went to speak with Dube's employers. "But they (the employers) still said 'no'. My employers didn't want me to stay with them anymore. They were afraid I would pass AIDS onto their children. They would not listen to anything else."
The nation's under funded and overburdened public health service has neither the medication nor the staff needed to handle the country's burgeoning number of AIDS patients.
"Patients in the advance stages of AIDS are told to go home," explained Agnes Kunene, a nurse in Manzini. "There is nothing we can do for them, so it is up to the families to provide care."
Private and non-governmental organisations fill some of the gaps, but the need far outstrips the availability of services. "Swaziland has a few hospices here and there, but nothing uniformed, and nothing that can meet the number of AIDS patients in the country," said Thuli Dladla, an official with the National Emergency Response Committee on HIV and AIDS.
Instead, Dladla said, most Swazis with AIDS go home to die. Many are either unaware of why they are ill, or are too afraid to tell their relatives. Families are known to boycott the funerals of people who have died of AIDS, Dladla continued, or else they attribute death to other causes, such as witchcraft.
In the absence of counselling and conventional treatment, HIV-positive Swazis are known to turn to traditional healers. "AIDS can be cured with a cleansing ritual," traditional healer Gogo Shongwe told IRIN. Shongwe's remedy includes the slaughter of a goat, and an injection of herbal medicine.
While recognising that stigma and discrimination hamper their work, HIV/AIDS NGOs are struggling to change attitudes. "In the 20 years we have lived with HIV and AIDS, stigma and discrimination have weakened our efforts to conquer it," Gcebile Ndlovu, a UNAIDS programme officer, told an AIDS awareness rally at one of the country's prisons recently.
"The sigma attached to HIV/AIDS may extend into the next generation, placing an emotional burden on children who may also be trying to cope with the death of their parents from AIDS," Ndlovu warned.
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