Same gate, new country

After traversing four European cities in 13 days, I have arrived and settled into my new home in Durban. While I have traveled to Durban numerous times before, the visible and abject poverty never fails to unsettle me each time I return. The side of the highway from the airport is littered with tin-roof shacks that house entire families. And as I pull up to 8 Musgrave Avenue—my current spacious apartment—and make my way through two sets of wrought-iron security gates, I am painfully aware of my privilege. I have a sneaking suspicion that this feeling won’t go away anytime soon.

I first arrived at this same gate just over six years ago to volunteer at the Sinikithemba AIDS Clinic of McCord Hospital. That summer, I lost my heart and soul to the spirit of South Africa. I witnessed true strength and courage in the face of enormous challenges: devoted health workers motivated by their faith and commitment to caring for others; children orphaned by AIDS and infected through vertical transmission of HIV; patients, who in the face of great stigma, never give up the will to live; and communities of “Gogos”, the Zulu word for grandmother, caring for young children. Most importantly, I witnessed the transformation that successful HIV prevention and life-saving drugs make possible.

Six years later, significant strides have been made to decrease the rate of new infections and increase access to care and treatment in South Africa. This progress was made painstakingly clear in US Secretary of State Hillary Clinton’s visit to South Africa earlier this month, part of an eight-nation African visit. On her trip she discussed the PEPFAR transition, what Reuters described as “symbolic of Pretoria’s shift from being a pariah to a global player in fighting the disease.” Secretary Clinton commended President Zuma and Minister Motsoaledi for putting the policies and systems in place to get 1.7 million people on treatment.

Despite signs of progress, it’s important to not lose sight of the enduring unemployment, poverty, crime and TB, among many other factors, which compound South Africa’s HIV epidemic and hinder prevention, treatment and care efforts. These ongoing socioeconomic challenges are a critical component to South Africa’s holistic and comprehensive AIDS response.

As I arrive on the same steps as I did six years ago (and many times since then), I am keenly aware that I have returned to a very different country—economically, politically, socially and epidemiologically.