AIDS in Africa: A Story That Must Be Told

Every day, 6,000 people in sub-Saharan Africa—more than twice as many as were lost in the September 11th attack on the World Trade Center—die of AIDS-related illness. And each day, nearly 10,000 people in sub-Saharan Throughout the region, reporters also face cumbersome government bureaucracies, some of which throw up Kafkaesque obstacles to obtaining what in the United States would be regarded as public information.Africa contract the AIDS virus. Though AIDS has fallen off the front page in America as life-extending drugs have dramatically reduced mortality rates in the United States, a widening epidemic confronts reporters in countries such as South Africa, Botswana and Zimbabwe.

I got a close-up look at some of the challenges these reporters face when I spent the better part of last year training reporters covering AIDS throughout the region, particularly in South Africa. My six-month stint in South Africa, which was sponsored by the Henry J. Kaiser Family Foundation, focused on helping reporters at the country’s largest English-language newspapers understand the complex science of HIV and translate that into layman’s language. But I also helped journalists develop story ideas, thoroughly explore those ideas in their reporting, and write stories in a compelling way with a strong human element. In the process, I learned as much, if not more, from the reporters I mentored as they learned from me.

Mistakes Journalists Make

By way of background, it’s important to know that the AIDS epidemic took off in sub-Saharan Africa nearly a decade after the first AIDS cases were identified in the United States. So it’s not surprising to find the African media guilty of some of the same sins that plagued early coverage of the epidemic in the West—a tendency to stigmatize people with HIV, to pass on unsubstantiated claims, and to hype putative breakthroughs in AIDS research.

The most egregious example of stigmatization that I saw was a headline on the obituary of a Gaborone woman who died of complications from HIV. “Have you had sex with this lady?” blared the headline in The Voice, a privately owned newspaper in Botswana.

In December 2001, the Sowetan, the largest newspaper in South Africa and the voice of the black majority, kicked off World AIDS Day with a frontpage story titled “US plot against blacks and gays.” The story went on to quote a man named Ed Graves, described as a black American AIDS researcher, who claimed that the AIDS virus was concocted in a secret cancer research program sponsored by the U.S. government.

Last spring, The Sunday Independent, a respected weekly in Johannesburg, ran a story titled “Threat of AIDS Orphans Gangs.” The lead was a model of yellow journalism. It said: “Time is running out for South Africa to come to grips with the nightmarish specter of feral AIDS orphans gangs— similar to those terrorizing Brazil—roaming our city streets.” The story contained no evidence that any AIDS orphans had actually formed gangs and, if they had, that the loss of a parent to HIV had anything to do with them being on the street.

Successes Journalists Have

But there are also shining examples of journalistic excellence. Lynne Altenroxel, a medical reporter at The (Johannesburg) Star, broke one story after another last year, including the government’s use of private investigators to track down the academics who leaked a government-sponsored HIV mortality report to the press after health officials tried to quash it. There was one key fact that the government was trying to suppress—AIDS, the researchers found, is now the leading cause of death in South Africa.

Kerry Cullinan, a reporter at the Cape Town-based Health-e News Service, consistently reports on complex AIDS-policy issues by illustrating their impact on people in a compelling way. Her story on home-based care for those with HIV began: “Under a camphor tree on a green hill in Bizana in the Eastern Cape, Chief David Mlandizwe sits with his council of elders, their horses grazing nearby.” AIDS, the chief explains, is claiming the lives of three or four young people every month and, until home-based care arrived, the village had little to offer them as they died.

And last spring, when a bizarre treatise endorsed by a top official of the ruling African National Congress posited that AIDS was the invention of Western capitalism, the staff of the weekly Mail & Guardian, based in Johannesburg, did some clever electronic sleuthing. Reporters tracked the mysterious document, titled “Castro Hlongwane: Caravans, Cats, Geese, Foot & Mouth and Statistics: HIV/AIDS and the Struggle for the Humanisation of the African,” to a computer in the office of South African president Thabo Mbeki.

Barriers to AIDS Reporting

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– Joseph NgomeTo cover these and other AIDS stories, reporters in sub-Saharan Africa often face daunting challenges. Some, such as those working for opposition newspapers in Zimbabwe, fight their governments simply for the right to publish. Others, including those in Kenya and Uganda, have to confront corruption in state-owned media.

At an AIDS reporting workshop I conducted with journalists from East Africa, for instance, several reporters asserted that they couldn’t pursue enterprise stories about AIDS without paying off their own editors. “What?” I asked. “Pay your own editor so you can do the work you are supposed to do?” Yes, they explained. For if a reporter actually wanted to do a story, that meant that the reporter was probably being paid off by someone else. Editors, I was told, wanted a cut of the take.

Throughout the region, reporters also face cumbersome government bureaucracies, some of which throw up Kafkaesque obstacles to obtaining what in the United States would be regarded as public information. In Botswana, for instance, it took Altenroxel and me two and a half days to get the government health ministry to approve a half-hour visit to a public health clinic to interview pregnant women coming in for prenatal exams. We traipsed from one office to another, first being told we had to be approved by the national health minister, then being told no, we had to be approved by the local health official, and finally being told to visit the town clerk. Two hours after schmoozing with him about everything from local sewage problems to the weather, we got the scrap of paper we needed. “Kindly permit these two lady journalists from South Africa to observe and ask a couple of questions,” the handwritten note said.

As significant as the government barriers, however, are challenges presented by media owners. To cover AIDS in the hardest hit countries in the world requires more reporters and more space. But, throughout the region, as in the United States, media organizations are paring their budgets by cutting staff, shrinking the news hole, and trimming spending on everything from news research to transportation.

At many papers, the reporter covering AIDS is a general assignment reporter who also covers the local schools, the police, and public health. Few reporters, even at major publications such as The (Johannesburg) Star, have access to the Internet at their desks, making it impossible to keep up with the latest medical information about AIDS. And for a reporter to spend any more than one day on a single story is often regarded as a luxury. For instance, one reporter with whom I worked for a week on a story about the emotional stress of caring for people with HIV was later told that she would never again be given that much time to pursue a story because the paper was just too strapped for staff.

The Emotional Toll on Reporters

One final note. While AIDS is taking a crushing toll in human lives south of the Sahara, it is taking an enormous emotional toll on those who cover it. For some, AIDS is not just a story; it is a watershed event in their own lives. One Ugandan reporter I came to know, for instance, lost both his parents to HIV and helped raise his two siblings while anchoring the nightly news on Ugandan television. Reporters throughout the region often spend their Saturdays going to the funerals of family, friends and colleagues. And many a news organization is running short on cash for employee medical benefits because workers with HIV are draining the coffers. Virtually everybody, including reporters, has a personal connection to AIDS.

As I traveled around South Africa, mentoring reporters in Johannesburg, Cape Town, Durban and Pretoria, I found one other thing that reporters had in common: the telltale signs of posttraumatic stress syndrome. How long, they asked, can you continue to sit in huts and interview emaciated children who have lost their parents to AIDS and who are now starving because there is no one to harvest the crops? How long can you drive off in your company car and dine at a five-star restaurant while you sort through your notes? How long can you hide your tears behind the mask of journalistic objectivity? And so, on a morning last May, I called the reporters together for a different kind of workshop. This one was facilitated not by me, but by professional grief counselors from the Center for the Study of Violence and Reconciliation in Johannesburg. The group was originally established to help people deal with the trauma of apartheid. I turned to it to help reporters deal with the trauma of covering AIDS in the most impacted country in the world. One by one, we pounded wet slabs of clay, trying to find the feelings that many of us had buried in order to do our jobs.

Huntly Collins, a 1983 Nieman Fellow, covered AIDS at The Philadelphia Inquirer during the past decade. She was a Henry J. Kaiser Family Foundation Teaching Fellow in South Africa in 2002 and is now director of science communication and advocacy at the AIDS Vaccine Advocacy Coalition in New York.