Dispatch From South Africa

After living here for two years while working for CRS, it’s good to be back in South Africa. Some of the faces I knew from here have moved on — aid work is a very transitory profession — but some are still here, and it’s been good to catch up this week when we could.

Despite my time here, I never quite get used to the contrast in South Africa. A trip through the fancy shopping districts of Sandton or Rosebank is a glimpse of Europe, or America, as well-dressed urbanites in BMWs or Mercedes chase the gold, in its new iterations, that first brought hopefuls flocking to Johannesburg, the Gold Reef City, in the mid-19th century.

But South Africa has the second-highest wealth disparity in the world — second only, I think, to Brazil — and for most South Africans, such wealth is simply unimaginable. Not far from the million-dollar homes and properties of Johannesburg’s wealthy suburbs, informal settlements sprawl across the dusty winter landscape, their tin roofs rusting from age and neglect. It is here that the face of South Africa’s greatest crisis — the HIV pandemic — is most readily visible.

With more than 5.5 million of South Africa’s 44 million citizens infected with HIV, South Africa had, until last year, the highest generalized HIV infection rate anywhere in the world. Though overtaken now by Swaziland — a small country ravaged by HIV and AIDS within the borders of South Africa — you need not look far to see the impact of HIV and AIDS in places like Orange Farm, an informal settlement of about 1.5 million people southwest of Johannesburg. I spent the day there today with CRS staff, speaking with patients who are receiving antiretroviral medications (ARVs) provided by CRS through the Inkanyezi Clinic.

In total, CRS is supporting more than 12,000 people in South Africa with these powerful drugs, which inhibit the ability of the HIV to hijack healthy immune-boosting cells within the body. As always, I was astounded by the stories of recovery I heard and saw this week, like that of Michael Baloyi, who I met yesterday at another CRS-supported ARV site. Ravaged by AIDS-related illnesses, Michael, aged 31, weighed just 70 pounds when he was admitted to the Holy Cross Home. His CD4 count, a measure of the immune-boosting cells in one milliliter of blood, was nine. By comparison, that of a healthy person would be around 1,000. For all intents and purposes, Michael was dead.

But ARVs brought him, and thousand of others, back. Sitting tonight in a clean, quiet hotel outside of Johannesburg, I already feel 1,000 miles away from stories like that. Heralded as a success story for making the peaceful transition from white rule under apartheid in the early 1990s, I see South Africa today at a crossroads. The next generation, and the one after that, will determine which South African reality will prevail — the wealth of the few, or the poverty and disease of the many. In the faces of those now receiving ARVs, you see the hope for a future many believed they’d once lost. Maybe that is as good an analogy as any for the country itself.

David Snyder has traveled to more than 30 countries with CRS, working in such crisis zones as Pakistan, Sudan, Angola, the West Bank, Lebanon and the Democratic Republic of Congo.

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