Fighting HIV, One Grandmother at a Time
Necessity Is the Grandmother of Invention in Khayelitsha
I recently returned from Cape Town, South Africa, were I attended the 5th International AIDS Society (IAS) Conference on HIV Pathogenesis, Treatment and Prevention. I and several other U.S. journalists had an amazing opportunity, at the invitation of Bristol-Myers Squibb Foundation's Secure the Future program, to accompany a European press contingent on a site visit to GAPA (Grandmothers Against Poverty and AIDS), an organization of grandmothers of AIDS orphans in the township of Khayelitsha.
The group of 50 or so journalists boarded several buses in Cape Town, and, during the drive, listened intently as our guide, Sviwe, provided some history on the area and its residents. Khayelitsha, which means "new homes," is a shantytown of nearly one million people located on the outskirts of Cape Town. It was established in 1983, as other townships became too overcrowded. Today, while living conditions remain extremely difficult, it is considered the most developed township in South Africa, with electricity, running water, a swimming pool, and even a shopping mall. Khayelitsha is so vast that it is impossible to tell where it begins and where it ends -- it stretches as far and wide as the eye can see.
For the cost of about 2,500 Rand (USD $300), an individual or family can purchase a prefabricated metal shack that has roughly 300 square feet of space. Residents then decorate the huts with brightly colored paint, metal scraps, and old billboards. Demand for the prefabricated "homes" is so high that they cannot be built fast enough.
Everyone in this country knows someone who has died of AIDS -- nearly one in three people in South Africa are HIV-positive. But here, amidst immense poverty and harsh living conditions, lies a safe haven for some amazing women. The grandmothers, who oftentimes are the sole breadwinners in their family, provide community outreach, training, and capacity-building to others who have recently lost their children to HIV/AIDS. They provide their sisters with hope and encouragement, and help them to gain the skills and access the resources needed to raise their newly-orphaned grandchildren.
We disembarked the bus and crossed the playground, and a chorus of jubilant, uplifting voices emanated from the main building, dubbed "the white house" due to its bright, white exterior. As we entered the hall, we were greeted by a lively group of African women in their 50s and 60s, singing in their indigenous tongue and performing traditional dances, many dressed in colorful garb, and some with brightly painted faces. So much energy, so much life! As we all found a place to sit, and extra chairs were brought in for the large group, Vivienne, our speaker, invited us to "take off our jackets" -- which, in their culture, means "welcome."
As we were served a delicious lunch of chicken, potato salad, tuna casserole, coleslaw, and pasta salad, prepared by the grandmothers themselves, Vivienne explained the different services that GAPA provides, and some of the stories of the people within it. Many of the women, she said, are hopeless and full of despair when they first arrive, not knowing where else to go, who to turn to, or what to expect next. But the grandmothers say to those just entering the program that there is no time for depression. As the saying here goes, "Depression is my name, but today she is singing a different song." One woman, who Vivienne translated for, described how she was so upset when she first came to the center, but after she joined the group, she was "healed." But, she added, even though she is healthy and happy, she is concerned for the children, who must now care and provide for the rest of the family.
The center holds various activities and monthly workshops, including support groups, educational assistance, skills-building, and even training on how to start their own home-based business, or supplement their income through making and selling handicrafts. They can receive financial assistance for the schooling of their dependents (there is no free public education in South Africa), which helps prepare the children for school while giving the grandmothers time to take care of their personal needs. There is also a program in the afternoons for primary school children made vulnerable by the absence of their parents.
Depression is my name, but today she is singing a different song.For whatever reason, I've always had this preconceived notion of what an "AIDS orphan" must look like. A child, wise beyond his or her years, forced to grow up much too fast, hardened and embittered by the unforgiving, cruel realities of life. And I couldn't even begin to imagine what life outside the walls of this safe haven must be like. But as I stood and looked around the playground that day, I was struck by its similarity to any other playground I had ever seen. The children, playing, swinging, jumping rope, and playing games, some even a bit mischievous and pulling pranks on me and each other, were full of life, happiness, laughter, and joy. It seemed as though they had discovered a community of others like themselves, and in the process had learned to support one another. They were somehow learning how to get on with life, and finding that there was still hope -- despite the bad hand they'd been dealt in life.
That evening, I found myself back in the comfort of my hotel room, soaking in a hot tub, and reminiscing about the people and places I had visited that day. I felt truly humbled -- gratitude suddenly took on a whole new meaning for me. I realized that some things are universal when it comes to HIV. Support, education, outreach, a sense of community. These are the cornerstones of the foundation upon which we must all learn to build a better life with HIV. Whether we are in Africa or rural Montana, learning about the different modes of transmission, methods of prevention and risk reduction, and how the drugs work in our bodies enables us to make smarter and more informed choices to safeguard not only our own health, but the health and safety of our partners and loved ones as well.
Since returning to the U.S., and over the last few months, I have thought much about these grandmothers and their eagerness to press on with the work they do, day in and day out, with little if any remuneration or thanks, other than the sense of fulfillment that comes from helping to educate and inform their families and their communities about the disease, the stigma, and the ravages of poverty. And above all, I think often of the children, whose names I never knew, but whose faces of hope and joy I will never forget.
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