All That Glitters: How HIV Caught Fire In South Africa
Carletonville, South Africa Nomsa Mogweba got in the truck with her two children and rode along until the driver said she should get out. She didn't hitch another ride because she figured she was far enough away from the powerful member of the family who, she says, had raped her first-born child. As the truck rumbled away, leaving Mogweba and her children standing on an unfamiliar roadside, she had no money and no husband.
She settled in a squatter camp that's a 10-minute walk from the East Driefontein gold mine, which has extracted more than 1.7 million pounds of gold from the earth, a bounty that, if sold at today's prices, would fetch close to $8 billion. Like the other 150 or so women in the squatter camp, Mogweba gets her piece of that fortune by selling herself to the miners. The going rate is 20 rand, about $3.25. Mogweba sometimes turns a john for as little as five rand, or 80 cents.
Women like Mogweba exist everywhere in Africa, caught in the pincers of poverty. But perhaps nowhere on this continent are conditions as favorable to her profession as in South Africa's gold-mining towns. The miners, who migrate from all over southern Africa, are barracked in all-male hostels, in which a dozen or more men share rooms as small as 20-by-20 feet. Most can afford to visit their families no more than one weekend every other month. With such separations from wives and girlfriends commonplace, the sex trade flourishesand so does HIV. Between 27 and 41 percent of miners around the town of Carle-tonville, where the East Driefontein mine is located, are HIV-positive. So are two-thirds of the women in so-called hot spots like Mogweba's squatter camp.
Recently released statistics show that 22.8 percent of South African women attending prenatal clinics are infected, and in the hardest hit regions, such as the province of KwaZulu-Natal, that proportion exceeds 30 percent. The rate of increasemore than 33 percent over the previous yearis also terrifying. Indeed, South Africa is considered to have one of the world's fastest-growing HIV epidemics, and the Carletonville area is one of the hardest-hit places in South Africa.
Since it usually takes seven or more years for full-blown AIDS to develop, Carletonville, like all of South Africa, is still at the beginning of its AIDS ordeal. Yet at Gold Fields SA, one of the world's largest mining companies, more than half the deaths in the Carletonville area during the last half of 1998 were AIDS related. And at the regional hospital run by Anglo American, another mining giant, Dr. Danie van Tonder says that deaths in mining hospitals used to occur mainly on the surgery ward, which cared for workers injured on the job. "But there's been a terrible change in the last five years," he says. "In surgery you cure people; on the medical wards you watch them die."
The Carletonville area is a key to understanding how HIV was able to spread so quickly in this country, which, just five years agowhen apartheid ended and Nelson Mandela became presidenthad alarming but still manageable rates of AIDS. Mark Lurie, a scientist with the country's Medical Research Council who is studying the effect of migration on the spread of the virus, explains how migrant labor has fueled its explosion: "If you wanted to spread a sexually transmitted disease, you'd take thousands of young men away from their families, isolate them in single-sex hostels, and give them easy access to alcohol and commercial sex. Then, to spread the disease around the country, you'd send them home every once in a while to their wives and girlfriends. And that's basically the system we have with the mines."
It is impossible to understand South Africa without understanding its gold mines, which descend as far as five kilometers underground and which have elevated the country's economy above any in Africa. The scale of the industry has literally altered the landscape: The Witswatersrand Basin around Johannesburgitself a former mining townis marked by massive, flat-topped hills made of earth that once lay underground, and locals laugh about the frequent earthquakes caused by shifting and settling in the vast hollowed-out labyrinth below. Each ton of Witswatersrand earth yields only a few ounces of gold, which explains not only why so much earth had to be hauled to the surface, but also why the industry imposed a draconian system of migrant labor that, in turn, paved the way for apartheid.
Quite simply, moving so much earth required a lot of workers, and turning a profit required that they be cheap. White workers, imported for their mining skill and experience shortly after gold was discovered in 1886, saw blacks as a threat to their relatively high wages and quickly formed a union which, among other things, forced industry and then government to adopt the Colour Bar, banning blacks from skilled jobs. The good pay secured by whites only intensified pressure to cut the cost of black, unskilled labor. Housing black families would cost money, and letting black workers settle permanently in mining towns would make it easier for them to organize and fight for higher wages. Apartheid's hated pass laws, which restricted the movement of blacks, grew out of mining company policies designed to bring workersbut not their familiesto the mines and then force them to go back home.
This migrant labor system, which at its height employed more than three-quarters of a million people from as far north as Tanzania, laid the groundwork not only for apartheid but also for other ills, literally. More than half a century ago, scientists documented that the migrant labor on the gold mines, with its signature single-sex hostels, bred epidemics of syphilis, gonorrhea, and other sexually transmitted diseases. Now, Lurie has found that migrant workers and their partners are about twice as likely to be infected with HIV as nonmigrant couples.
Not all these migrants are miners. But according to 1996 data, only the government houses more people than the mining industry; more than 235,000 people work in the gold mines alone. And because of the vast wealth generated by gold, other minerals, and diamonds, the mining industry played a lead role in shaping the racial policies that forced blacks to migrate for jobs in many industries, including agriculture, manufacturing, and even the service sector. The gold mines, then, simply epitomize South Africa's migrant labor system and the way it amplifies HIV.
Of course, no single factor can cause an epidemic as huge as AIDS in southeastern Africa, where in some countries more than a quarter of the adult population between the ages of 15 and 49 is infected with HIV. Poverty, poor health care, illiteracy, and female powerlessness mark the region. Other sexually transmitted diseases, which make it much easier both to transmit and contract HIV, are rampant.
Pointing to such cofactors, the mining industry downplays the effect of the migrant labor system on the spread of the virus. "Personally I would say migrancy is not one of the major factors," says Dr. Peet Rautenbach, a health advisor with the Chamber of Mines, the leading industry association. "More important is the country's transport infrastructure," which is indeed highly developed in South Africa. "But," counters Laurie, "the transportation system would be irrelevant if people were able to work in their home towns or bring their families to live with them."
South Africa's epidemic has grown "explosively, and it doesn't seem to be hitting a plateau," adds Salim Abdool Karim, one of the country's leading AIDS researchers. "That suggests some engine driving our epidemic that's different from elsewhere. It's not just poverty and commercial sex," which are found throughout the continent. "Migration," he says, "is one of the key explanations." Indeed, by scattering the virus far and wide, migrant labor can make an epidemic grow extremely quickly. And because migration corrodes families and social cohesion, leading to increased numbers of sexual partners, it sustains the very epidemic it helped inflame.
Seven hundred meters below the surface of the earth, and descending deeper on wooden steps, one hears a mechanized roar grow louder and louder. Around a corner, it becomes literally deafening, and the source of the noise slowly grows visible in a gloom so thick it makes the whole scene look underwater. Four pairs of men are driving tungsten-tipped hydraulic drills into the dark rock, boring narrow tubes that will hold sausages of orange-sheathed explosives.
Mining manager Alton Taylor calls this, West Driefontein's Shaft 7, "a Rolls Royce setup." But while the shaft is indeed one of the country's newest and most modern, the basic work of mining is the same here as in any gold mine in the country"really tough," as driller Tshetlho Lebotse tersely puts it.
It's hot underground, up to 90 degrees. The driller's whole body shakes with the vibration of the drill, yet to avoid injuryand to make his per-hole bonushis concentration must not flag. The drills are so loud that even shouting directly into someone's ear is futile, so despite earplugs, everyone worries about hearing loss.
And, of course, there is the ever-looming danger of a "rock fall," an underground avalanche. The Chamber of Mines only records injuries that force a miner to miss 14 days or more of work. Each year, about two percent of miners suffer such injuries; in 1997, the last year for which statistics are available, more than 5700 miners were injured, of which 279 died.
Such danger undermines efforts to convince miners to wear condoms, says Sy Elhadj, who heads the southern and eastern Africa team for the United Nations Joint Programme on AIDS (UNAIDS). "If you work hundreds of meters underground, where every day you risk having a big stone fall on your head," he explains, "then you will have a completely different perception of the risk of a virus that you can't see and that will live in your body for 10 years before you become sick." Indeed, studies conducted by Brian Williams of the Council for Scientific and Industrial Research show that many Carletonville miners don't wear condoms or even perceive themselves as in danger of becoming infected.
Stress, danger, loneliness, lack of privacy in the hostels: all these contribute to the need to blow off steam at Carletonville bars like Marcello's. Some minerssuch as quiet, serious Daniel Solo, who during the day helps lay explosives undergroundsay they come to this bustling bar just for the beer and the camaraderie and the soccer showing on the television. Yes, Solo says, sometimes one of the women in the back will come over, rub her leg against his, and say that she's selling a good time. But, says Solo, who sees his girlfriend for three days every month, "I just tell her I'm not that kind of guy."
Twenty-seven-year-old Xolani Mbatha says he, too, sleeps only with his steady girlfriend, but a few minutes later he winks and says "of course" he's here to pick up a woman. Twenty-two-year-old mine welder Robert Sembilerie is even more up front, saying he has "no regrets" about having women on the side because his girlfriend doesn't satisfy him in bed. Sembilerie usually scores just by buying drinks and flirting, but around the corner is the President Hotel where, he says, a room, beer, and a prostitute go for 70 rand, about $11.
That's expensive, but those who can't afford it can amble over to what Yodwa Mzaidume, an AIDS education worker, calls "the bedroom," a rent-free field of high grass and low trees where clusters of sex workers spend the day waiting for customers. Such open-air brothels exist near most mining hostels because, as Mzaidume explains, poor women from all over the region believe that miners have "baskets of gold." Some women, she says, come just for the weekend. "It's common practice for a woman to loiter at the mine entrance, and even if 10 men pass her by, she knows the 11th or 12th will buy her."
Research assistance: Tien-Shun Lee and Reetpaul Rana
This is the first of Schoof's series on HIV in South Africa.
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