Disguising Aids in South AfricaBy Hugh Sykes
BBC, in South Africa
South African President Thabo Mbeki's attitude towards HIV and Aids is once again under scrutiny.
He claims: "I don't know anyone who has died of Aids." So why does it continue to dominate the problems facing the South African people?
This is still a surreal and confusing place.
One minute you are in a vast modern shopping centre, with marble floors, a glass roof, a multiplex cinema, numerous cafés and restaurants, and smart cars parked outside.
Five minutes drive away there is a shanty town of shacks and houses constructed with mud and bamboo canes, with public water taps, public pit latrines and no electricity.
Back in another smart town at some traffic lights, small boys dressed in torn trousers, ragged t-shirts and no shoes, fight furiously with each other over a single piece of bread thrown to them from a passing car.
And in this rollercoaster ride from township to shopping mall to squatter camp to smart house with electric gates and swimming pool, there is something even sadder than all the visible deprivation.
When I was last here two and a half years ago, I spent some happy hours with two new friends: Zandile, a nursery nurse from a squatter camp, and Sibusiso, a musician from a township.
Zandile was celebrating her new home. She had moved from a shack into a new flat, where she ran a mother-and-toddler group. I took a photograph of her smiling and waving goodbye from her balcony. I shouted from the car that I would come back one day and give her the photo.
Last week, I called Zandile's cellphone. It was answered by a total stranger.
I called her friend. She inhaled sharply when I asked after Zandile. "Oh no, she is late. She passed away a year ago".
I'm sorry, I can't see you this weekend, Hugh. We are burying a friend tomorrow
Friend of Sibusiso
"Why?" I asked. "She was only 35!"
Her friend replied: "She was very sick, very very sick".
I had photos of Sibusiso too, taken while he and his acapella music group rehearsed in a small hut next to his township home. Sublime voices, fantastic high kicks between hand-claps, a traditional Zulu dance.
I was pleased with the pictures and eager to give them to Sibusiso. I called his cellphone. It cut straight to voice-mail.
I left a message, and called another friend to arrange a meeting. They said: "I'm sorry, I can't see you this weekend, Hugh. We are burying a friend tomorrow. Do you remember Sibusiso? He died on Tuesday."
"Why?" I asked. "He was only 36!"
The friend replied: "He was very sick, he was very very sick".
'Abide With Me'
Deep in rural Zululand, north of the Tugela River, Sibusiso's funeral ceremony was conducted in an open-sided marquee on rough grass outside a round thatched Zulu home. We were surrounded by sugar-cane fields.
In the shade of lemon trees next to the tent, a small brass band of township children played Abide With Me from the Tune Book of the Salvation Army.
A Christian pastor sat behind a table holding a bible while the Lord's Prayer was recited in Zulu. Friends stood and shared their memories of Sibusiso.
At one point, his best friend Mluluke had to walk away. He stood at the edge of the sugar cane, quietly weeping. When he returned, still wearing his black suit and tie, he led the rest of Sibusiso's music group in a Zulu dance.
The mourners in the tent clapped their hands to the rhythm and laughed and cheered. The coffin was loaded into the hearse, a pick-up truck with a hard roof.
Sibusiso's wife and small son and daughter climbed in and sat on the floor next to the wooden box.
The coffin was open until the end of the ceremony. Sibusiso was unrecognisable, emaciated and horrifyingly thin.
And now I have to say that Sibusiso was not his name. A friend told me that he had Aids, and his family would be ashamed.
And Zandile was not the name of the nursery nurse smiling in the photo that she will never see. She too had Aids.
But neither Sibusiso nor Zandile are likely to appear in the HIV statistics.
Doctors here often protect families from perceived stigma by not writing HIV or Aids on death certificates. It is not a lie. It's just not the whole truth.
People don't actually die of Aids. What kills them tends to be the so-called "opportunist" diseases that thrive because of the damage that the Aids virus, HIV, causes to the body's defence system; infections like TB, pneumonia, and even influenza.
So President Mbeki's statement that he does not know anyone who has died of Aids is technically correct. But it is a bit disingenuous, and Aids campaigners say such remarks are profoundly unhelpful.
Professional bodies like the Medical Research Council and the Actuarial Society of South Africa estimate that between 4.8 and 6.6 million people in this country have HIV.
In the car on the way back from Sibusiso's funeral, one of his friends looked sadly out of the window and said: "I have four more funerals to go to next week."
From Our Own Correspondent was broadcast on Saturday, 7 February, 2004 at 1130 GMT on BBC Radio 4. Please check the programme schedules for World Service transmission times.