South Africa: Environmentalists of the World, Welcome to Durban!

23 November 2011
blog

Durban — Environmentalists of the world, welcome to Durban! You may have heard that our city is a top international holiday destination with year-round beach weather. You'll know that our Indian Ocean port is the busiest in Africa. We believe we have the best soccer stadium, a legacy of last year's FIFA World Cup, and are proud of our newly revamped beachfront.

But that's not all that we're known for. Durban, and our province of KwaZulu-Natal, has the world's highest levels of HIV. With less than one percent of the global population, South Africa has 10 percent of its HIV infections, and our province has 10 times more HIV than anywhere else in the country. This is in part because KwaZulu-Natal is South Africa's second most populous province, with more than 10.5 million people. (The home of Zulu culture, KZN, as it's known, also has Africa's largest Indian population, plus a small minority of white and mixed race people.)

High HIV prevalence is nothing to brag about, but here's something that is: Durban boasts some of the world's top researchers on HIV and Aids. This claim is borne out by the standing ovation at the most recent World Aids conference for Durban's own husband-and-wife research team of professors Quarraisha and Salim Abdool Karim. Their breakthrough in testing an anti-HIV drug known as Tenofovir is seen as one of the most promising advances in international HIV research to date.

Gynaecologist, obstetrician and epidemiologist Dr. Sengiziwe Sibeko is another member of the team at the University of KwaZulu Natal's Centre for the Aids Program of Research in South Africa (Caprisa). Born and raised in Durban's Umlazi township, the 39-year-old will soon take up a fellowship to study towards her PhD at the UK's Oxford University, with a continued focus on anti-HIV research.

Is this just a chance to blow my vuvuzela about my hometown, or is there a link between Aids and climate change? Indeed there is, for they are "two of the most important 'long wave' global issues", according to UNAIDS, which predicts that HIV and global warming could combine to threaten global food security. So as the region most ravaged and still threatened by HIV and Aids, and as your COP17 hosts, we will be watching closely to see if and how the Durban talks respond to these twin challenges.

The current implementation study of the new anti-HIV drug focuses on those most affected by AIDS – women – because they are the ones who apply the vaginal gel that contains Tenofovir. This leads me to note what could be another international breakthrough in our part of the world: after decades of demonstrating HIV prevention by fitting condoms onto wooden models of the male sexual organ, CAPRISA's pioneering scientists are promoting a demonstration model of the female sexual organ.

"The female genital tract is shrouded in secrecy," explained Professor Quarraisha Abdool Karim, a 51-year-old mother of three. "Women know surprisingly little about their bodies, so we start with these models."

Made of molded plastic, as opposed to the wooden penises well known to veterans of Aids education classes, these models of the vagina are used to show women exactly where to insert the microbicidal gel applicator. There is, after all, a choice of openings.

Motivation for using models of genitalia is said to date back to the public demonstrations of condom use in the early days of the Aids pandemic, which deployed a broomstick to represent the male organ. Professor Abdool Karim repeats the oft-told tale, also a staple of local stand-up comedians, that this inadequate modelling led to some couples having unprotected sex – with a condom draped over a broomstick next to the bed.

Visit Sibeko at any of the reproductive health clinics where the Caprisa study on the anti-HIV gel is being conducted, and you can't miss the larger-than-life vagina by her examining table.

"I can tell you from my clinical experience over the years that women don't really know their anatomy," said Sibeko. "So you can't just expect them to self-insert (the gel) if they don't know where things are supposed to be going at the bottom of their bodies."

While the doctor is proud to be part of the fight against Aids, she's also proud of the women of Durban and KwaZulu-Natal who have volunteered to be part of the study. She says that, like the researchers, these volunteers are motivated by a desire to contribute to the quest to prevent HIV transmission.
I'm sure that all of us who live here will feel even more pride if this locally based study confirms the effectiveness of the Tenofovir drug. And we all look forward to the day when Durban is again known for sun and sea, rather than HIV.

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