A South African journalist probes into the disconnect between modern medicine and a severely stressed tribal culture in a nation where some six million people, more than one in eight citizens, are HIV-positive.
Steinberg (The Number: One Man’s Search for Identity in the Cape Underworld and Prison Gangs, 2005, etc.) focuses on two men: Sizwe Magadla, a shopkeeper in a small, poor, remote village in the Lusikisiki district of the country’s Eastern Cape Province, and Dr. Hermann Reuter, who runs an antiretroviral treatment program there. In cooperation with the provincial health department, the international organization Médecins Sans Frontières (Doctors Without Borders) has set up local healthcare clinics to test and administer antiretroviral medicines. With Sizwe as his interpreter, Steinberg spends time at Lusikisiki’s clinics, observing the treatment program, getting to know nurses and patients and following the workings of a support group for HIV-positive patients. In Reuter’s view, if good AIDS treatment is provided, people will come and get it. However, Sizwe refuses to be tested, and Steinberg wants to understand why. Conversations with the skeptical Sizwe reveal not just a fear of demons and witchcraft and a suspicion that white doctors’ needles impart sickness, but deeper issues. The author eventually realizes that Sizwe will not be tested because to be found HIV-positive would mean he could not marry or have children to carry on his name. His individual story reveals the limitations of treatment programs in a place where medicine has long been seen as an ingredient in white political power.
Meandering and laden with extraneous details, Steinberg’s narrative nonetheless builds a disturbing picture of a society caught in a tragic situation with no clear solutions.