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October 4, 2003
Killer of Dreams
By NICHOLAS D. KRISTOF - New York Times
WAMHLANGA, South Africa
One of the great mysteries to me about AIDS in Africa has been this: Why do people not take precautions during sex even
when they see friends and relatives dying?
It's easy for Westerners to say that widespread promiscuity is the root of the AIDS problem in Africa, where the virus
is transmitted mainly by heterosexual contact. And there's definitely something to that. But the reasons for reckless promiscuity
go beyond hormones, and I came to understood them better near this town of KwaMhlanga in the northeastern part of South Africa,
in the tin shack where Gertrude Tobela frets about her teenage daughter.
Ms. Tobela, 34, slim and quick to smile and now to cry is the first in her family to graduate from elementary school,
high school or college. Two years ago, she was at the top of her world, preparing to graduate from the university, have her
second child and join the middle class.
Now she is another African widow, poor, dying and heartbroken because she cannot protect her children from the same fate.
She is but one of 30 million Africans with H.I.V./AIDS (24 will die of it while you're reading this column), but her tale
underscores how H.I.V. in Africa is not just a virus but also a self-replicating cycle of AIDS, poverty and hopelessness.
Ms. Tobela's world began to collapse when her husband, Simon, an electrician, was found to have AIDS. Then she tested
positive for H.I.V., apparently after getting it from him. And her newborn son, Victor, turned out to have caught the virus
from her.
Her husband died last year, and she is now too sick to hold a job. She survives on $22.50 a month in government child
support and spends her time wondering about who should raise Victor after her death. "I think maybe if I die first, before
him, then maybe my mother can take Victor," she says, her voice catching.
Ms. Tobela seems typical of Africa's AIDS victims. In Africa, 58 percent of H.I.V. carriers are female, and among teenagers
with H.I.V., more than 75 percent are girls. This is largely because of an explosion in quasi prostitution between young girls
and older men.
"It's not just promiscuity," said Blanche Pitt, director of the South Africa office of the African Medical and
Research Foundation. "It's poverty. It's desperation."
As young women become infected, so do their babies. One-fifth of pregnant women in southern Africa have H.I.V., and worldwide,
800,000 babies a year get H.I.V. from their mothers.
Ms. Tobela managed to talk in a composed way about her death and Victor's. But she broke down when I asked about her 14-year-old
daughter, Thabang (she has a different surname, which I'll keep to myself). "My daughter left me because she wants liberty,"
Ms. Tobela said, weeping. "She is so sexually active, and she stays in bars and rental rooms."
It began in June, when Thabang began coming home late. Ms. Tobela screamed at her and then beat her, but it did no good.
The girl ran off to live with her grandmother, but then stayed away for days at a time. After the grandmother beat Thabang
as well, she ran away again.
I searched the town for Thabang, and finally found her at a relative's house. She is very pretty, with a fondness for
makeup, well spoken and smart. I told her that her mom scolded her only because she loved her. Thabang began to cry. "She
doesn't love me," she said fiercely. "If she did, she would talk to me instead of beating me. She wouldn't say these
things about me. She would accept my friends." Thabang insisted that while her friends slept with men for cash or gifts,
she did not.
Why would girls who have seen what AIDS can do commit suicide by sex? Part of the answer is that the disease carries a
mechanism for perpetuating itself: it first devastates families financially and emotionally, then leaves adults unable to
mind their children, and finally breeds crippling despair. Death, poverty and hopelessness so suffuse Ms. Tobela's tin shack
that I can imagine them impelling a mixed-up 14-year-old girl into the arms of older men for a few coins.
When a girl's mother and brother are dying, when a family's middle-class dreams collapse in a ramshackle hut, when there
isn't enough money to pay for Victor's visits to the doctor, when a girl's world is shattering in slow motion she doesn't
know what to live for.
And so AIDS insinuates itself into the next generation.
Youth, Alcohol and HIV
GET HIGH, GET STUPID, GET AIDS
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