iSERVICE

A South African tragedy

Jeremy Gordin on the life and death of NLN

1. NLN

This is about NLN.

She was born in November 1952 in or around Qumbu, Transkei, now Eastern Cape. Presumably, she had the typical traditional upbringing of a semi-rural Xhosa female person.

One can get a pretty good idea for what that would have been like (more or less) from Nelson Mandela's A Long Walk to Freedom and Mark Gevisser's biography of Thabo Mbeki, and doubtless from other books with which I'm unfortunately not familiar.

I'm not certain when exactly the Nationalists managed to insert Bantu education into that part of the world. But it seems that NLN, who went no further in school than either standard 6 or 8, was fortunate enough to go to a mission school. Her basic literacy and numerical skills were better than those of, for example, her children.

Her children might have gone farther at school, one of them in fact to matric. But Bantu education was, as we know, aimed at the creation of hewers of wood and drawers of water; unless one had an exceptional teacher (Wilkie Khambule in Soweto springs to mind), going to school was, in "educational" terms, a pretty pointless exercise for most people.

Actually, Bantu education might have been the worst sin, or one of the worst, committed against South Africa and South Africans by the Nats. Let the present screwers-up of the educational system take note.

Just recently I have discovered that, of NLN's five children, the first two were the fruit of a dalliance that she had as a relatively young woman. The biological father is apparently still alive somewhere in Cape Town.

It's not surprising. When younger, she was very pretty, with a great smile, and, when the fancy took her, she was quite a good mimic and had a fun sense of humour.

For example, NLN and her buddies in the neighbourhood used to refer in isiXhosa to someone - whom I won't name because she is quite a well-known Johannesburg "activist" - as "the woman with the large prow", a reflection not so much on the size of the woman's bosom as her rather imperious air.

Later NLN married. Her husband, W, died about six years ago. In the 1970s or early 1980s they, like so many, travelled to live in Johannesburg- because that is where the work was.

He worked in some sort of hardware concern; she became what we used to call a "maid" but now refer to, somewhat primly, as a domestic servant. What else could she do? She wasn't trained for anything else. Her mother had been a nurse or nurse's aide, but NLN hadn't gone that route.

In 1985, she started working part-time for me. I lived then in Bellevue, Johannesburg. When I went to the US in 1988, journalist Ann Crotty took over my flat and NLN worked for her until 1992.

In fact Crotty - who came from the relatively civilized world of Dublin, Ireland - found herself driving NLN in the middle of the night through the wilds of Soweto to Baragwanath hospital for the birth of NLN's last child, or maybe it was the birth of her penultimate one.   

I return to Seffrica in 1992 and have lived since then in Parkview, where NLN worked again for me - and for what turned into my family. My children were born in 1994 and 1998. NLN was their "carer" (as we say, more politically correctly, these days). They have known her - and she them - all the days of their lives. I have known NLN for 27 years; my wife has known her for about 24. In 1994 they went to vote together.

2. Hospital & Death

Last year NLN's varicose veins became really toxic and then she got pneumonia and so went into the Helen Joseph hospital. Then in January this year, she suddenly lost a great deal of weight, her varicose veins flared up again, and she grew very confused.

Seems obvious what was wrong, doesn't it?

But NLN said she'd been tested for HIV and the result was negative. Besides, while her husband was in Johannesburg (till about 1992, when he went to work in the Eastern Cape), she'd been monogamous. And afterwards she had continued to live a monogamous lifestyle, as it's quaintly called. Yes, she would see her husband once or twice a year till he died and we don't know what his "life style" involved. But she insisted her HIV test had been negative. I had NLN tested for TB; the result was negative.

NLN grew even more confused and weaker. About three weeks ago, she was admitted to Helen Joseph again. Besides being a nightmare for NLN (obviously - she was extremely ill), it was also a nightmare for us. The thing was that we didn't know what was actually wrong with her; we therefore didn't know if she was receiving the correct treatment; we didn't even know, though my wife visited her in the hospital, if she was receiving any treatment.

Because of the almost-hysteria about confidentiality that has become the shield behind which every "medical professional" in South Africa hides, including doctors - and so it has to be, you will tell me, and maybe it does - because of the confidentiality song and dance that has come in the wake of AIDS, you can find out nothing unless you are a member of the family.

But what of her family?

The oldest daughter is a teacher in the Eastern Cape. This is, for many people, a long way away, especially if their salaries, such as they are, are going on, say, food or school uniforms and they don't even have money for air time. The second son is, it turns out, in a prison near Benoni.

The third son stayed with us for a while but after he had been charged with assault for the third time, a magistrate put him away for 18 months. That was three years ago. Where he went from prison, whether he ever came out of prison, no one knows or has been able to find out - and I know my way around the jail system better than most.

For reasons that are not entirely clear, or are the business of the people involved, the second daughter and the youngest son had "disappeared" into Alexandria Township some time ago, cutting off contact with their mother. 

So, yes, of course you can't have a non-family member know confidential information ...but what happens if the family is to all intents and purposes absent? 

Anyway, to cut a long story short and to pass over the anxiety of my family (which is I suppose irrelevant), NLN died on Tuesday morning at Helen Joseph. She was six months away from retirement - after four-and-a-half decades of hard work.

Notwithstanding the death certificate attesting that she died of natural causes, the immediate cause of death was apparently something called VRE.

This is, to give you the tersest definition, "Vancomycin-resistant Enterococcus, or vancomycin-resistant enterococci (VRE), are bacterial strains of the genus Enterococcus that are resistant to the antibiotic vancomycin."

To put it more simply: NLN's immune system or CD-4 count was so low that there was no way she could resist one of those super-bugs that are so strong that even the strongest antibiotics (e.g. Vancomycin) can't kill them.      

So, yes, NLN had HIV. But she had refused steadfastly to tell us or even some of the doctors who treated her. They had in fact started her on antiretrovirals at Helen Joseph but it was too late.

Why didn't she want us to know? Well, there is no place here now for a treatise on the stigma of HIV/Aids and how some of the leaders added to the stigma rather than helping to attenuate it. You know this story anyway; or you ought to know it.

3. A South African Story?

The above is not a very unusual story. In fact I would hazard that it's a common South African story.

Here's a person who was born with all kinds of abilities. But the education system foisted on her and others like her was such that there was not much for her to do but a species of mindless labour.

Here's a person whose family - who might have been supportive and the source of good counsel to her - never really stood a chance themselves as the result mainly of destructive and cruel social and political systems put in place by others.

Here was a person who got a disease through no fault of her own. Well, it's not a question of "fault". But the fact that there exists such a stigma, related to HIV/Aids, is the fault of others and their ignorance and fear.

If NLN had been able to speak about the disease, if she had received a higher level of counselling than was available at the local clinic, she could have been given antiretrovirals - and in all likelihood she would still be alive and could be enjoying her retirement. But it was not to be.

Sounds more to me like a classic South African tragedy.

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