In a double-storey building emblazoned with the face of late Archbishop Desmond Tutu, inside Professor Linda-Gail Bekker's office a bookshelf is stacked with titles on general medicine, HIV/AIDS and tuberculosis (TB). Against the bookshelf, a mannequin leans dressed in a white doctor's coat, a stethoscope protruding from her pocket; on her head a sparkling tiara and a pink Venetian mask. Pinned to a wall is a picture of raised fists bearing the hashtag #youthinaction. Next to Bekker's computer, luminous red shapes throb inside a lava lamp.
This tableau perhaps captures the driving passions and quirks associated with the petite physician-scientist with the lilac hair. To colleagues, Bekker is simply known as "LGB" - short for "Linda-Gail Bekker". An A-rated researcher (with South Africa's National Research Foundation), with a string of awards including several for her contribution to the global HIV response, Bekker's career from early on pivoted around social justice. Former president of the International AIDS Society, this year she joined the board of Dutch-based non-profit organisation the Access to Medicine Foundation, which advocates for big pharma to distribute lifesaving drugs to low- and middle-income countries.
Propelled by a want to create better lives for people, while "fascinated and thrilled" by medical science, Bekker chose infectious diseases as her core career challenge. Combining research and community outreach is her strong point.
Next year will mark the 20th year since she established the Desmond Tutu Health Foundation [DTHF] inside the University of Cape Town [UCT] with her husband, renowned TB researcher, Professor Robin Wood. From small beginnings in the 1990s as the HIV Research Unit at Somerset Hospital - one of South Africa's first public clinics to offer antiretroviral therapy, under directorship of Wood - today the Desmond Tutu Health Foundation and HIV Centre has a fleet of five "Tutu Tester trucks", a TikTok channel and a new gym-style health park that encourages youngsters to get both "ripped and prepped", a reference to PrEP. PrEP stands for pre-exposure prophylaxis and involves taking certain antiretrovirals to prevent HIV infection.
'Get ripped, get prepped'
Wedged between mountains and the sea along the Cape Peninsula coast, the township of Masiphumelele is home to tens of thousands of people (reliable estimates are hard to come by) on about 40 hectares of land. Despite its name which means "we shall succeed" in isiXhosa, living conditions here are dire. It is overcrowded, sanitation is not what it should be, and infectious diseases like HIV and TB are rife. This is the site of DTHF's youth centre, opened in 2011. And since September it is also Mpilo health park - with gym equipment and facilities for soccer, netball and basketball at a yearly membership fee of R150.
"I'm constantly looking for new ways to reach people," says Bekker. "So we've had a youth centre down in Masiphumelele for years. But we realised that we were missing young men aged between 17 and 29. So we have built a health park alongside the youth centre, basically it's a gym with all the latest equipment. So the message now is: 'get ripped, get prepped.' You know, if you want to look gorgeous, if you wanna be attractive, build your muscles, but have a healthy penis too."
Bekker explains that they charge membership fees as this creates a perception of value. She hopes the health park will become a blueprint for similar facilities to be rolled out countrywide.
"And in the middle of the health park, we still have the sexual reproductive health clinic," she says. "Plus a mental health support component. We are seeing a ton of mental health difficulties post-COVID. So just some basic support. Somebody who can sit next to you and say: 'I see you, I feel your pain. If you are using substances, can you use less? If you're smoking, can you smoke less?' We're trying to address the non-communicable diseases as well. There is an epidemic of obesity now. So we are trying to say to young women: 'this BMI [Body Mass Index] is going to get you into trouble. What can we do, sister? How can we help you? What's your diet? Can we advise around the dietary side?' You know, gentle engagement around non-communicable diseases."
Another current DTHF project is "FastPrEP" - in partnership with the Bill and Melinda Gates Foundation, plus the Western Cape and National government health departments since 2019 - which endeavours to have PrEP distributed in a "fun" fast-food modelled manner, ranging from discreet home deliveries and WhatsApp support to PrEP ambassadors on social media channels like TikTok.
'A dream come true'
At a small boardroom table, one leg folded underneath her on a chair, Bekker recalls a happy childhood surrounded by droves of cousins (her mother was one of fifteen children) on a pig farm in Zimbabwe. She recounts being the first in her family to graduate from a university.
"My granddad on my mother's side got to about fourth year of medicine and then decided he wanted to be a farmer," she says. "My childhood really was just subsistence farming in many ways."
Despite a flare for drama and the stage - her "Paris Hilton tendency" - Bekker wanted to become a doctor from as early as she can remember.
"My first memory was making sure that I got into medical school," she says. "I am a terrible achiever, competitive to a fault, which can be difficult. I just love the arts, but I truly loved science too, and it was a dream come true for me when UCT said I could come here to do medicine."
Bekker graduated from medical school at UCT in 1987, followed by service at McCord Zulu Hospital and Eshowe Provincial Hospital in Durban, returning to Groote Schuur in Cape Town in 1993. Her initial ambition to pursue care for geriatric patients made way for research into infectious diseases, as the HIV/AIDS pandemic loomed darkly over the country and its health agenda.
In these heady times, her love story with Wood started in the disinfectant-smelling corridors of Somerset Hospital, in Green Point. Bekker worked at his clinic as part of research for her PhD and for pocket money. "Robin was doing these very exciting new antiretroviral studies, which was terrific," she recalls.
"And I guess part of our story was that we used to go and watch art movies together, which I love. So, foreign art films at the Labia Theatre and then afterwards we'd go to a pub and have discussions about it. And this one movie we watched, I think it was a Chinese or Japanese movie, it was around ballroom dancing. And Robin said to me, 'You know, my grandma used to make us do ballroom dancing'. And I said, 'That's amazing! I love dancing.' So I went home and opened the newspaper, and there was this advert for Latin American dance lessons. And I thought, well, this is a sign! So I signed us up for Latin American dance lessons. And to Robin's credit, he didn't back off."
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Bekker obtained her PhD in 2000 and married Wood in the same year. The couple have a 22-year-old son named Ollie. On her office wall, drawings made by a young Ollie commemorate special family moments, including when his parents became professors. Bekker notes her son's unusual childhood, growing up in a household with regular dinner-time conversations about CD-4 counts [a measure to check the health of the immune systems of people living with HIV.] Ollie in turn, keeps Bekker abreast of youthful trends.
"So what they [young research participants] tell me is that they want tailored, direct information, preferably in their pockets," she says. "So on their phones, not written down. I mean I barely know a young person who reads anything if it's not on YouTube, or TikTok. My own son doesn't. So with our services [at the DTHF] we've had to adapt to that. We're really putting a lot of effort into social media and short, sharp messages."
Two years ago, Bekker co-lead the Sisonke study into early COVID-19 vaccinations for South African healthcare workers, alongside her peer at the University of the Witwatersrand, Professor Glenda Gray.
Note: The Bill and Melinda Gates Foundation (BMGF) is mentioned in this article. Spotlight receives funding from the BMGF, but is editorially independent. Spotlight is a member of the South African Press Council.
