A Reflection of HIV in Post-Apartheid South Africa

Often times when we think of South Africa our minds wander to Nelson Mandela or even Desmond Tutu, well known leaders who paved the way for human rights during the apartheid, a word that is enriched with history as it reminds us of the suffering that many endured for 50 years. The Apartheid, which is translated in Afrikaans meaning “apartness”, was a system in South Africa, which was created by the National Party government in order to advance the minority white population. Though the apartheid is no longer a running system it’s damages still live on as it has affected the way of life for many South Africans, specifically black South Africans. As destruction permeated it’s way through the lives of many people it was able to have extreme effects on one’s health. HIV, which was known as a taboo disease throughout the years began to make its way through South Africa becoming AIDS which took the lives of millions. South Africa soon began to be the “poster country” for HIV infections. Statistics show that there are approximately 7.1 million people living with HIV in South Africa being one of the largest in the world. I am interested in understanding how policies and socioeconomic status can contribute to one’s health. As I examine these factors, I would like to analyze how destruction generated by the apartheid has played a role in the widespread of HIV as well as how we can relate this back to a broader scale of global health and development.

Policies can be used for good intent for a greater good or can deliberately used to achieve an unreasonable outcome. When the apartheid started slowing making it’s appearance in South Africa, government officials had put policies in place which inhibit black people from living in areas where their white counterparts were located. This caused many to live areas known as Bantustans, which were territories set aside for black people. Within these Bantustans, healthcare was primarily governed by each individual Bantustans. The South African government did not govern the quality of health services in these areas. Overtime these places became known for maltreatment and malpractice because of the limited resources they have. Soon after the end of the apartheid, the government promised to promote primary health care services and prevention through the National AIDS Plan which would strengthen the Bantustans health systems. This plan, though cause many problems because it didn’t face the problems that had already existed from past policies and existing organizations.

As we see that policies implemented had a negative impact on the widespread HIV, we can also see how the socioeconomic landscape of South Africa post-apartheid played a crucial role in the HIV epidemic. Policies links to socioeconomic status, which then links to our health. Many people don’t realize that HIV often times can be a connecting factor to poverty or vice versa. According to STATS SA, three million South Africans were pushed below the poverty line. Black South Africans were the most negatively group impacted by poverty. Since limited resources and economic opportunities weren’t readily available many chose to engage in other avenues that may benefit them and/or family. For example, adolescent girls who come from lower income families may engage in transactional sex which is exchanging sex for material benefit. This action puts adolescent girls at a greater risk for HIV. Many of these girls are living in Bantustans which are already facing neglect by the health system.

As we look at how policies and socioeconomic status has been a contributing factor to HIV in South Africa, we can take a look and see how we can relate this back to global health and development work. Using South Africa as a model, we can see that different establishments can clearly target our health. It’s important to note that in order to provide proper access to health care as well initiate different services we must understand the history of the community we are serving. Institutions and systems have negatively impacted the way many communities take care of their health. Hopefully for those of us who are working in this field we can understand that in order to dismantle inequalities in health we must aim at the root cause.