Activists discuss health reform in South Africa

Estelle Timar-Wilcox

Two celebrated advocates for accessible HIV/AIDS treatment in South Africa visited Macalester on Tuesday, Sept. 25 to discuss their work.

Vuyiseka Dubula and Mandla Majola both partner with Acacia Global, a nonprofit that works to support NGOs in South Africa on issues of social justice and cross-cultural understanding. The organization’s Executive Director Kevin Winge introduced Dubula and Majola, who were in town for an organization fundraising event in Minneapolis on Wednesday night.

“They get up every morning in conditions that none of us have to experience, facing issues that are almost unimaginable for most of us here,” Winge said.

Dubula served for eight years as the General Secretary for the Treatment Action Campaign (TAC), a widely praised group in South Africa dedicated to pushing for access to care for HIV and AIDS.

“TAC is really considered the model for organizing communities to fight HIV/AIDS,” Winge said.
After working with the TAC, Dubula founded her own nonprofit, the Activist Centre for Education and Development, which focuses on providing leadership opportunities for community activists and women living with HIV.

Majola, who recently founded the non-profit Movement for Change and Social Justice, focuses on men’s health – specifically, men living with HIV – and on eliminating gender-based violence.

As activists in South Africa, both Dubula and Majola must contend with the country’s deep socioeconomic inequality.

Since the end of apartheid and the establishment of democracy, the West has largely regarded South Africa as an emerging economy and an economic leader of Africa. But debilitating racial and economic divides persist.

“We were sold a half-baked cake,” Dubula said, referring to the incomplete reforms in South Africa’s democratic government. “We are the ones who need to make sure it will be fully baked.”

Dubula’s activism is deeply rooted in her personal struggles with the flawed South African health care system. When she was diagnosed with advanced HIV in 2001, she was told that she wouldn’t be able to receive care because of her inability to pay for medication, which was far more expensive in South Africa at the time than it was elsewhere.

“I have seen my grave,” Dubula said. “I never knew I would be alive today.”

Her activism, as well as Majola’s, is also influenced by her experience with gender inequality in the country.

As the leader of the TAC, Dubula was paid far less than her male counterparts. Now, she works to empower female community leaders in South Africa by creating spaces for them and working for better childcare, maternity leave, and breastfeeding policies.

Majola pointed out that the most recognized leaders in South Africa’s history have been men, despite the activism of women throughout the country’s history.

“Men assume leadership without thinking twice,” Majola said. “It’s our entitlement.”

These gender roles, he said, are learned from parents at a young age and often fueled by gender-based violence in the home. Both activists are concerned with changing this learned culture of violence.

“We see our mothers beaten by our fathers and we think that’s fine,” Majola said.

Exposure to gender violence as a child, he added, is a strong predictor for future abuse.

Violence against women is disturbingly common in South Africa, as it is globally. A 2013 study reported that as much as 59% of women in South Africa have experienced domestic violence at some point in their lives. Dubala said that gender-based violence is not only learned by men, but the patterns are often internalized by women. She recalled her experience witnessing abuse in her childhood home.

“I expected that love involved violence, and when your partner is not violent to you, you are not loved enough,” she said.

Gender stereotypes and violence not only cause physical and psychological harm to victims, but also contribute to the spread of HIV in the country. According to Dubula, a number of girls and women contract HIV through unsafe or violent first sexual encounters.

Once infected with HIV, however, women are more likely to seek treatment than men. Because of the stigma surrounding the illness men often die from the disease without ever being tested for it.

“Men in South Africa are very reluctant to take responsibility for everything, starting with their health,” Majola said. “You see it with HIV.”

Both activists and the groups they’ve worked with have seen success in recent years. The TAC’s lobbying and involvement in court cases, for instance, has helped South Africans have access to HIV medication and medication that prevents mother-to-child transmission of the disease.

However, both stressed the importance of the work still left to do in South Africa and around the world. Deep inequalities exist in the United States as well, Dubula pointed out, speaking of the sprawling homeless camp at Hiawatha Avenue in Minneapolis.

Dubula and Majola plan to continue working to empower communities to pressure the government for health care and human rights.

“The issue is to ensure that after we’re gone,” Majola said, “we leave a better world for our children.”