This resource is hosted by the Nelson Mandela Foundation, but was compiled and authored by Padraig O’Malley. It is the product of almost two decades of research and includes analyses, chronologies, historical documents, and interviews from the apartheid and post-apartheid eras.
18 Sep 2000: Schlemmer, Lawrence
LS. The moment a house stands empty it's invaded by squatters and then you've got thirty families. There's one just round the corner and they put security guards there. The security guards then take bribes and then turn round and say, what can I do, they threatened me, by which time the people are in and you can't get them out. They're protected by law. So you do run the risk
POM. They are protected by law if you leave your house vacant and squatters enter into it? They are protected?
LS. If they have lived for longer than two weeks you need legal steps taken to get them out. You can't simply phone the police and say I have trespassers. In any event, even if you could the police will not act. The police station will tell you to your face, "We're not acting against squatters, go away, we're not interested in your problem, go away." So, and there's an empty house just three houses up and already I see squatters are moving in and then you can't get rid of them. When that happens then people get wind of it and immediately they get jittery about buying a house. So it's just sheer survival. If I was younger, but at this stage I've got to start looking after capital. I can't afford the price to drop any more.
POM. I'd come here to talk about AIDS, but then I made a quick list and one of them was social disintegration. Every time I come back I get the feeling that while at one level you have stable governance structures they almost exist in isolation, that under that you have increasing social disintegration whether it's gang rape, child abuse and the kind of gratuitous crime where, which you talked about, of somebody up the road, a couple of kids just shooting the person outside their door and not even bothering to take the car, where police performance doesn't appear to be getting any better, family violence in the townships endemic. What's happened to the entire fabric of society that over a ten year period by almost every indicator of normal living you're living in a fortress?
POM. Which you are right now, surrounded by gates on both sides, the barbed wire, I saw it coming up on every house, which wasn't here before, every house has triple barbed wire on top of it. What happened?
LS. I think one has got to start fairly way back. The African family is a problem. It was a very strong and powerful institution in its extended form. As you know the child socialisation in African traditional society was not located with the conjugal parents, it was located usually with elders, which included the grandparents, but most especially there were age regiments among the youngsters, the children and youths. These age regiments they were age cohorts, children of that age, and leadership emerged in these cohorts which was under the supervision of the elders, not directly but they could see what they were doing and the socialisation of children was formidably affected because it came from both sides, it was both peers and grandparents. Now it left the parents, the direct parents, with a kind of ambiguity of role. They were not necessarily more important than other relatives in terms of authority figures. If a youngster, this still happens in traditional society, if a youngster stepped out of line the elders would contact the headman and the headman would call the father in and the father could then go to the child and say, I have been called in by the headman and the elders and I must tell you that unless you stop doing whatever you're doing a tribal discipline will be imposed, you will be lashed, and it was pretty persuasive. You didn't fool around. And to this day, if I look at an average survey, the fear of crime in the rural areas is very much lower than it is in urban areas because there is still a residue of the collective authority.
. Let me just give you an example. Here's a question: which one of the following are you most dissatisfied with? I will read through a list and then ask you to name the one that dissatisfies you most. Now if you take the level of crime, now look at the percentage, it's 13,8% in tribal areas and in black townships it's 30%, Asian townships 35%. You can see the break. In the metropolitan areas it's 56%. Now it's that kind of difference so that the tribal areas are still very much the areas where you can call upon collective authority. You don't have to wait for the police, all you have to do is take it to the elders and they take it further and they may call the whole age regiment and they will say there's one of you that has been stealing from the shop. Now you must point him out and bring him to us now. Go away and bring him to us. It's that kind of thing. It's very tough. The immediate parents never had to act as autonomous sources of authority. Now under urban conditions the conjugal family has not yet strengthened to the point where children can be controlled.
. I'll give you an example, I was interviewing a guy the other day in an area north of Pretoria in the Winterveld. He was a civil servant and he had moved out from an urban area in Pretoria, a black guy, with his whole family into the sticks. He had huge commuting distances and I said to him, "But why did you move so far?" And he looked at me and he said, "To save my daughters' lives because in the urban area I cannot impose the authority which will keep them safe from AIDS. I know that if I left them in Pretoria they would have five to ten years life expectancy. I brought them here because the rural customs still offer some protection." I said, "Yes, but you're a strong person, strong personality, cannot you impose?" He said, "No, I can't exercise sufficient discipline on my children. They say yes but they'll do something else because the peer group is all powerful and I cannot control the peer group. So to save my daughters' lives I am now commuting 50 kms a day to get to work. It's a reasonable trade off."
POM. Does that not make a certain argument for strengthening traditional structures, having traditional structures play a larger role in local government even if they don't confirm to the perfect forms of democracy?
LS. In theory yes but traditional leaders haven't got the social competence to compete with modern councillors. They are out-argued, outwitted, every time. In the area where there is interaction and there are many areas in the country, in the Eastern Cape, where there has been interaction between the modern activist type and the traditional type. The traditional leaders have found that they haven't got the linguistic fluency to cope with a modern activist who is smart, full of shit, and quick, whereas the traditional leader is slow and needs a lot of time because that's the mode of existence in rural areas. It doesn't only apply to Africans, it applies to the whites as well with the result that in places in the Eastern Cape the only way that the traditional leaders have been able to secure their authority in some of these marginal areas is by becoming violent. They've actually evicted the civics, chased them away. About three or four years ago in parts of the Eastern Cape the traditional leaders just expunged the civics, chased them away because they said we can't cope with these people so let's get rid of them. You can understand it won't work. Sooner or later a civic authority would reassert itself and traditional leaders would end up being brought into line. I don't know whether there is a solution.
POM. Why do you think that the level of, say, rape, gang rape, violent crime, is higher in South Africa than in other even urban parts of Africa? Is there something particularly special about the extent and intensity of the crime that occurs here that sets it apart from other urban areas like in Nairobi or Harare or Cairo? Maybe not going as far as Cairo, going down more to Maputo? Or do you just keep better statistics?
LS. I think we keep better statistics. I'd say Nairobi, I wouldn't say that that's necessarily better than SA because that has had a long tradition of gangs, thugs, gangs of thugs that rob motor cars and that sort of thing. For the past 15 years or so people have felt nervous about going out at night in a vehicle. But if I compare SA with West Africa, even though West Africa is full of corruption and their pickpockets are smarter than SA's and their scams, their scam artists are more sophisticated, I definitely feel much safer physically in West Africa than I feel in SA, much, much safer. Much safer in places like even Ivory Coast and Ghana. I haven't spent much time in Nigeria, I can't speak, because you may get robbed but you won't get killed. It's this gratuitous violence.
POM. What accounts here for the lack of value, total lack of value put on human life? There were a couple of kids just playing with their guns and just shoot somebody rather than take the car, saying well we got our kicks or whatever, it doesn't matter to us. What accounts for that element of gratuitousness and why even as the country is emerging out of apartheid does that appear to be worsening rather than getting better?
LS. I think it's lack of community. For people to begin to respect human life there are two routes I think. The one route comes through middle class socialisation where little kids read books about bunnies and teddy bears and they're entertained endlessly about the consequences of cruelty, so they develop a mindset which is humane and it stretches from these surrogates for humans which is little bunny-wunnies and things like that and then it becomes a mindset. That's the one route. The other route I think is community where if you injure somebody badly you are answerable because that person is a member of a community and the community which is normally your community, or a local community, will act. So you develop a respect, if not a humane mindset, for human life because it is more than just a human life. Now there is an African philosopher, Mbiti, Professor Mbiti, he was professor at Makarare, very interesting, one of the best African writers I think, a fairly old-fashioned guy. John S Mbiti, African Religions & Philosophy, a well-educated guy, he got his PhD at Cambridge, and he makes the point, he says it quite bluntly, he says in African society murder is not murder until it is the murder of a member of your community. John S Mbiti, African Religions & Philosophy. I wrote that quote in a joint paper for an international conference a couple of months ago and this was censored out, it was taken out. It was not politically correct. Sociologists can no longer quote things like this.
POM. Murder is not murder unless it's a member of your community.
LS. Unless it's a member of your community. He said it's just a tragic fact that you respect life because life is part of the body corporate but if a stranger, a total stranger is in front of you then the norms do not apply. You may murder a stranger. Now this is not particularly African. I think that 16th and 17th century villages in Europe applied the same thing. You respected life which is part of the body corporate but if a guy came from 50 miles away from another village he was a stranger and he could be killed. If he annoyed you sufficiently you could kill him and it was only if the superior authority of the Duke or whoever was in charge cracked down on you that you were held accountable, but the village would not mind a stranger being murdered. This is where the overarching authority of the Catholic Church then became quite important.
. Now we have lost community in SA, we talk endlessly, every policy document talks about communities. There are no communities, there are aggregates, mass townships, mass squatter camps. They are aggregates, they are not communities. Modern town planning or, if you like, blame it on apartheid, but it would have happened without apartheid because it's happened in other countries, mass town planning with urbanising people just simply destroys communities. Only recently, just in the last few years
POM. But there's not a single policy document that said publicly, that doesn't mention the word 'community', 'community involvement', 'community planning'.
LS. But they are all referring to self-styled people who operate as spokespeople but they have no purchase of the place, they don't necessarily. When we run surveys nobody ever recognises these names and the community spokespeople. It's all artificial, it's a particular mode of political articulation, this endless mention of community, community, community. It existed to some extent during the struggle because you had street committees and area committees and those things were precious and they should have been retained and they should have been incorporated in their form into government. Then we would have actually built in the discipline and coherence that the struggle brought into the modern system, but the government did not hesitate to go for a formal, European, local government model where councillors were elected and taken out of their communities and given so many committee duties in the councils that they never get back to their communities anyway. They are paid salaries which immediately enables them to move out of these areas so the councillors for an area may or may not live in the area. So in other words modern politics, we had the germ of a new modern community life by virtue of the liberation struggle, it was destroyed. Now you get a pathetic remnant in a few civics that still cling to existence here and there but basically they're a joke, they have no more coherence or organising capacity. The people still want them, they're desperate for them, but they're no longer there. They've all been promoted up, they're all members of the new elite and it's a national elite, it's not a community based elite.
POM. I'm reminded of, I think we may have talked about this question years ago, that in the US in the inner cities what happened was that as soon as you got any kind of education you got the hell out, so all that was left were the poor, impoverished, the drug addicts, the lost, no role models, no community, and in the same way here I would think that if you make it out of the township you don't say to yourself, you know what, I'm going to go back once a week to revisit my cousins and my aunts and whatever. You say, thank God that's out of my life, and there's a breakage, a disconnection between where you came from and where you live.
LS. In any event you can't really go back to communities very effectively because you've acquired a new identity. Now there's an African fellow who works for the Free Market Foundation and I think he's put his finger on it, he said we actually have a new ethnic group which has been established in SA, it is the new elite but it's more than an elite, it's a new ethnic group because it is an ethnic group which is particularly proud of its command of English and along with command of English there's a whole style of communication which the new elite have developed informed very substantially by the trade union movement.
POM. What's his name?
LS. Themba Nolutshungu. Now we did a survey recently for the Pan South African Language Board where we asked people whether they understood the language of political speeches made by their own leaders and 49% said no, we don't understand what they are talking about. A black journalist the other day phoned me up from a political meeting and said, "Please Lawrie, for God's sake tell me what is filibustering? Is it something sexual?" I said, "No it's a political party that talks up a storm and delays decisions just be keeping the race going." At least that's how I understand filibustering. He said, "My God! You know this man used filibustering over and over and was hammering the DP and was saying it was a vile bunch and they were all just filibusters and we all thought that he was saying that they were sexually depraved."
. You see, this is the thing. The other day there was a minister talking on radio. Now radio is for the people, all your illiterates can listen to the radio even if they can't read your speeches. It's very important. He was making the point that the Democratic Party was wrong in saying, and he used the words, "That government and the ANC are co-terminus, we are not co-terminus", and he didn't deviate from that word, he spent about 20 minutes talking, elaborating on his theme and it was all built around his concept of 'co-terminus'. He didn't make even a simple concession to a Post Office clerk by saying, look they're actually not one and the same thing, there is a difference in their roles. No he just used co-terminus because he's so bloody proud of his word. Ah! and these words are badges of honour, new badges of honour, big words.
. So you can't go back to the community. The community is kept happy by the fact that the government does enough to signal that it's on their side. And why, how? It does this by every now and again having a go at whites. If you're having a go at whites you must be on our side, so it's OK, that's fine, they're our guys. We don't understand them, they use big words, they drive big cars and they have funny hairstyles but they're on our side. It's enough, it works. It won't work for ever but it works for now. So community is gone. There is no community.
POM. Throw that into the whole question of AIDS. As I said to you before I've been talking about AIDS now for two, three years to ministers, to everybody. The responses I get have been shocking. I see AIDS as a plague engulfing the whole southern - not a pandemic any more but something that's just slowly taking the guts out of southern Africa. One gets no sense of any awareness of this that will alter the economic structures or social structures. There will be no economic miracle, all you will be doing is building cemeteries and there will be no economic growth, there will be no sustainable development, there will be very little. In fact the country may have been freed in order in a way to turn in and die upon itself. Where do AIDS and community fit despite the fact of all the bad signals being given by Mbeki and members of his government?
LS. I don't think they're the main thing, although they don't help obviously. Mbeki's antics don't help, but still it's not the main thing.
POM. When you talk about a seven-year old boy who essentially - that's the problem, with a six-year old girl. Why can I know people say it's taboo, this country is in denial, everyone's in denial, what would you put your finger on?
LS. I don't think it's any single thing, it's a combination of things but they add up to let's just make the initial point that where a collective realisation emerges that there is a very dangerous virus associated with sexual activity, one can reasonably expect people that exercise, or have the capacity to exercise some degree of self control, to take steps to avoid risk and the gay communities in the USA are the best example, I think, and that turnaround was remarkable after the scare. And here as well the gay community, they are almost obsessional now in risk avoidance. So it hasn't happened in Africa among heterosexuals, with heterosexual AIDS. So there's something wrong in the degree of self control. Now admittedly I'm not pontificating, this is one area of life where self control is bloody difficult, let's admit that, it's tough.
. But let me come back to the rural tradition. The rural tradition permitted, formally permitted among pre-pubertal and post-pubertal children what they called 'intercural(?) intercourse'. In other words as long as you did not penetrate, if it was between the thighs, and thank goodness the thighs were usually full enough to make that a reasonable proposition, then you could fool around and that was permitted. But anybody who penetrated was beaten nearly to death. So kids could be big deals, they could engage in sexual heroics and do all the things they wanted to do but they did not penetrate. That was an enormously powerful institution in traditional society but it required the regiment system and it required grandmothers and it required the odd virginity test to check, like a back check in an interview, which works, 15% back check, 15% virginity test is enough because any girl of 14 that was found not to be a virgin they would not rest until they had found the young man and he would probably lose interest in sex for the rest of his life. So that worked. They did not go the route of trying to embed restraint in the super-ego, to use that quaint, old-fashioned term of Freud. There was no guilt socialising. That's a middle class thing, but it's not only a middle class, it's not only a guilt thing.
. In a very strong conjugal family unit young girls identify with their fathers, the father is the big hero, he's really a very important person in her life and they are far less vulnerable to the blandishments of youths because there's - I'm not saying that anything happens between them and the father, it's all an emotional identification and part of it is the fact that nothing happens between them, but the father becomes a huge emotional barrier to just lying down and opening your legs. Now the African conjugal family is weak. It's weak not only in rural areas, it's weak in urban areas, it's never, ever had a chance to strengthen. It's only strengthening in the middle class but it hasn't strengthened among the masses. It's weak in moral authority and it's weak in interactional intensity. This is seen in the ease with which concubines are taken and accepted, it's just general.
. Now this means that the young women have no restraint left, they're nothing, and our Minister of Health, it's not me, it's not some right wing white saying this, our Minister of Health has said we have the highest rate of teenage pregnancy in the world. Point number one. Point number two, whether you read a book on the American ghetto situation, magnificent book, it was very intense participant observation of street corner society but it wasn't called it wasn't the original Street Corner Society, it had another title, and it concentrated on the dilemma of young black youths, males, who are brought up by women and the women have to work, the women are over-stressed, their fathers are perambulatory, they come and they go and they may be there or they may not be there, but they are generally bad-mouthed by their mothers as a useless, layabout son-of-a-bitch, that sort of thing. So these kids grew up with a real problem about male ego identity. They don't know how to define themselves and the really telling parts of this book were the way this bloke actually quoted the songs and the ditties that these black youths in Harlem and other areas of the states were singing about their mothers and the one theme that he picked up, there was constant vilification of their mothers and vilification of women in a desolate attempt by these youths to try and build up their own male identity because they had nothing. They had been brought up by women and they had to try and put some distance between themselves and the women that brought them up. He said that this translates into two things. First of all they're going to have to go to extraordinary lengths to prove their male competence so they will become ultra-macho which is what happens here and it appears to me what happens in the US as well. So they're sort of big deal, macho.
. The second thing is, they have very little respect for women. They have a very great ambiguity about women but it's a love/hate and there's a tendency to want to impose your dominance on women and that I can tell you is rife here and it's one of the things that explains this incredibly high teenage pregnancy.
POM. Does that also account for the incredibly high rate of rape, gang rape?
POM. Where it's not something about sex, it's about imposition of
LS. Imposition of your forcing yourself, showing that you are the boss, the male predator. If you add to that the fact that we have at any one time a 25% level of other sexually transmitted diseases, 25% of the adults of SA throughout the country, one in four, has got an STD. Now with STDs of course you do get abscesses and infection, transmission of the virus is about 400 times more likely. 400 times more likely than between two healthy partners. So you've got two people and with the 25% STD rate you've got to multiply or divide your chances of one or the other having some kind of broken skin, it's one in two, because two twos are four, take the square root. Now you can imagine, I mean there is no way in which this disease has just taken off like that. It's rampant, very special circumstances. To that extent Mbeki is right by saying that there may or may not be a virus but that doesn't explain it. What he's struggling with is trying to explain it but he couldn't say what I'm saying because I would not be published if I were to write this, it's as simple as that. So he's using a surrogate
POM. You would not be published in this country or you would not be published anywhere?
POM. South Africa.
LS. Yes, newspapers would send my article back and say sorry, it's a bit tough, we can't handle it. Possibly some overseas journal may not, but not that I'm interested in writing it. If it needs to be said, it needs to be said here and it can't be said here. That's the problem.
POM. Because of?
LS. Political correctness. This is saying there is something of African everyday culture, that's what it boils down to.
POM. Does it also relate to, as many people say, that talking about sex is taboo?
LS. No, no, no. Political correctness is carried by the middle class and they love talking about sex because they never do it, they just talk about it, whereas the other guys do it and never talk about it. No, no, it's not that. It's just that you cannot any longer say anything here which would be taken as suggesting that there is somehow some sort of difference between the races in any way which is meaningful. I'm just explaining why the epidemic has taken off here and, my goodness, there's nobody everybody knows that gay lifestyles are pretty, pretty loose and pick-ups in bars were par for the course. But even one of the loosest lifestyles in USA or Europe realised, hang on, there's a risk here and I'm not going to take risks, and they turned the thing around. I think it's worth a special analysis in how the gays turned it around. I think it would be enormously useful. But here these factors just account for the fact that it's out of control.
. There's another thing which is particularly sensitive and which you can't write about, that where a couple of medical doctors have written about it in medical journals and that is the almost tradition of what is called dry sex. African women in certain traditional areas in SA, in Zimbabwe, in Mozambique, Swaziland, because they have a lot of children tend to get fairly loose so they have to do things to provide some friction and there are various herbs that are used, powders and things like that. It's what nice middle class girls do if they want to fake virginity when they're married, they put talcum powder in, it's an old trick throughout human society. But this has become a very desirable thing and that is high levels of friction. Now this is particularly dangerous within the AIDS virus because the AIDS virus has to penetrate through broken skin, broken membrane and dry sex is fatal. So all these things are combining to increase the propensity for the transmission of the disease. As far as I'm concerned it's easily explicable.
. There was another study done by an Australian couple, two anthropologists, I think I mentioned it last time but I can't remember their names. They came to SA and they gave a paper at the HSRC which was very impressive. They looked at infection rates in different kinds of kinship systems. Where residence of the married couple is matrilocal where residence post-marriage is matrilocal, in other words where the husband is expected to relate mainly to his wife's parents, including the father, the rates were lower. Where the male takes the woman into his kinship system, in other words where he can be an interlocutor between his kin and the woman, the infection rates were higher. They tested it in a number of societies in central and southern Africa. Statistically it held. In other words their explanation was with matrilocal residence of the bridal couple the young man realises from early on that he has to be very careful how he treats women because there is a father who can beat your head in if you don't treat his daughter right, but where it's patrilocal residence they couldn't give a stuff because it's my kin and if she complains I will tell them that she's a liar and give her a good beating, sort of thing. You see what I mean? So they said there are two different traditions going in different kinship systems and the patrilocal residence is one of the factors which has increased the spread of AIDS. As well as a whole lot of other things they controlled transport routes, they controlled all the things which normally are associated with high AIDS.
POM. Where would one find this study?
LS. This is a tough one. You know, Padraig, it's one of those rare events where you go into a seminar and you really learn something and that happens about once every ten years. I wrote it all down on a piece of paper and put it in my pocket and that was it. It was a husband and wife team, two Australian anthropologists.
POM. Done about when?
LS. Ten years ago.
POM. Can you remember what conference it was?
LS. They were coming through on their way back from Central Africa and they were simply travelling through, going back to Australia and they stopped and they gave a seminar at the Human Sciences Research Council. It was really fantastic research.
POM. So one sets out to go back in time, ten years, and find out. Would there be copies done? Copies of seminars at the HSRC?
LS. Well the thing is it wasn't a formal seminar, it was an informal seminar. They distributed a couple of papers. The HSRC has changed so much that the people who would have been interested are no longer there.
LS. But listen, I will keep a weather eye open for any when I pack, who knows, I may discover something.
POM. OK, I'll come over and help you pack! Do you mind if we keep continuing for a while?
LS. That's fine.
POM. Who do you work with? Who's working in this field?
LS. I've had to take an interest in AIDS because I've been doing scenarios of the long run future and obviously it's a major dimension. I've been very disappointed by the general debate. I'm sorry I missed this study 'To The Edge'.
POM. I will e-mail it on to you, I have it on e-mail.
LS. Let me just get the little study I did on the level of vulnerability in the population. Have a look at it some time.
POM. One of the things I'm working on, as distinct from the other things I'm working on, is that I edit a journal, I think I told you, a Public Policy Journal, and I do special issues on occasion and I'm doing a special issue on the social and economic impact of AIDS in South Africa. I started out looking for macro-economic studies that might have been done and found that there were none. In fact the number of studies done in the area for the long term impact the disease might have are practically zero.
LS. No, there is one, have you come across Quatec(?).
LS. I think she's probably done more. You must get hold of this. Unfortunately this is my only copy.
POM. That's OK. Dr Robert Shell.
LS. That's a worthwhile article, Christine Quatec. Shell is really retreading, establishing knowledge which he does well enough. Many people think he's alarmist. I don't think he is but many people do.
POM. This woman is at?
LS. She's the Economist at ING Barings Bank.
POM. They'd be listed here in Johannesburg, right?
LS. Yes, it's ING Barings. Remember Barings when that rogue dealer in Singapore and they went bankrupt they were bought out by a Dutch bank, ING, so now it's ING Barings. That's a good article, it's a very, very thorough review.
POM. This was published by the Christian Adenhauer - ?
LS. Konrad Adenhauer. She's got the effects on the economy model, every single thing, on operating services, on wage costs, everything she's tried to do.
POM. This was done in? It's an occasional paper?
LS. During 2000.
POM. So I can get in touch with her. Is there anyone else doing work?
LS. No, Quatec is definitely the leader in the field. The other people that have done some work are Metropolitan Life, the insurance company.
POM. Peter Doyle, yes.
LS. Doyle. And that's about it.
POM. For example, does anyone know when Trevor Manuel prepares his budget estimates for short, medium and long term how he factors in the impact of AIDS or whether or not he does?
LS. No, they're just starting. It's only recently come to their attention what some of the consequences are and where it has a knock-on effect in a number of policy areas. Obviously it increases indigents and they are beginning to factor it in. I know people, I've been to discussion groups in the Department of Welfare where they're factoring it in now quite actively.
POM. So when you do scenario planning, what kind of scenario planning are you talking about?
LS. Well this is not yet finished but it's water usage, 'Distribution of South Africa's population, economy and water usage into the long term future.' Now that's done for the Department of Water Affairs. This has aged me by five years, water, terrible, ball-breakers. They wanted forecasts up to the year 2025, so I've had to factor in AIDS. But you know in the end the best you can do is you take the reigning wisdom of the insurance industry, Peter Doyle and people like that, because our official statistics are so bloody awful. They really are, terrible. It all depends on the tests of sero-positive women. All our statistics are derived from the tests of women attending anti-natal clinics and we thought we had a comparable trend line over the years which showed an increase, and then last year suddenly a plateau.
POM. Last year it jumped?
LS. No, a plateau, in other words flattened off, very sudden. Now some very supposedly well informed people in government then said, perhaps we've turned the corner. But you know perfectly well that infection rates can't change from one year to another, it's a more gradual process. A year is too quick to reflect. So it turns out that they test at a sample of clinics, they draw the sample well enough, it's all done by good little cookery book random samples, stratified, etc., etc., but then they asked the clinics whether they are willing and able to co-operate and in Cape Town, for example, 40% of the clinics that were included in one year were not included in the next. So it turns out that it's a lousy sample, it defeated its whole purpose right at the end and we don't know what the infection rate is among pregnant women. We don't know. So we are in a sense living in a kind of blissful oblivion.
. We hear some horror stories about teachers and nurses that are HIV positive but all of this is comment emerging from the system, it's not a study. So it's all subject to under or over-information. We don't know. We do not know what the situation in SA really is. The most important thing is that we don't know at what level the disease is going to peak. In other words, will the infection rate peak at 24%?
. If you look at the models from the insurance industry most of them suggest it's going to start peaking, the infection rate, round about 24% - 25%. Botswana is already heading for 30%. Why should SA be different? We simply don't know at what level the disease is going to peak. Obviously you've got to know this in order to do long term forecasts. There's a hell of a difference between a 25% infection rate and a 30% infection rate. Botswana will probably peak at 32% - 33%. Are we going to go that route? We don't know. Nobody knows. All roads lead back to Peter Doyle in a particular sense because the insurance companies are constructing their models and these models go up and down. Metropolitan have just re-run its model where they lowered their infection rate, or they lowered the curve. We don't know, we simply do not know. All we know is that it's bloody serious.
POM. What steps do you think must be taken? Is the country at a point where it in one sense has to declare a health state of emergency which says we've got to find out, there will be compulsory testing as there is for TB? We have to get the data, we have to ensure there will be no discrimination afterwards but there comes a point when an individual right gives way to the collective right. Is the country anywhere near that? Can it face that?
LS. Not yet.
POM. More people have to die?
LS. Yes. I'm afraid the disease has got to enter a much more mature phase before you see there's still denial. In other words the politicians are still calculating that by blaming somebody else they can survive it unscathed. That's the whole purpose of this whole business about poverty because ultimately they've got a rationale about poverty and that is it's due to apartheid and the global economy, it's the IMF and the World Bank. So they think, well, they can probably survive the crisis but once people are dying and they've just got more and more AIDS orphans then they will have to get serious, but then it will be too late. I think this period of denial will probably go on for another 18 months or so because the deaths are now mounting very rapidly, you can see it coming through in the system, defaults on bonds, that kind of thing. Statistics are beginning to bite. With the infection rate it goes like this, the deaths lag and then they come up, eventually they go together but we're just into this steep increase in deaths. So it's a bit soon for politicians to respond.
POM. I know the country is out-conferenced and out-seminared in all kinds of discussions and papers, but if you had a small conference, international conference of a group of South Africans and a group of perhaps Americans, very tightly focused, where do you think it should be putting its emphasis? Where should the emphasis go?
LS. Well I think obviously the question of how serious is the disease is one session, and that's probably an early session. I would definitely try and get somebody from the United Nations Office in Botswana to try and come to the conference and have somebody from the insurance industry like Donnington or Doyle and somebody from the Health Department here. The UN person could probably double because the UN have modelled our disease, the AIDS Division in the UN, and their model is different to the South African government's model. They actually have a higher infection rate. So it would be worth trying to get somebody from the UN with knowledge of Botswana and SA and southern African statistics because we're not an island, the infection goes across boundaries. So one UN person, one insurance type, the model designers, and one health person from SA at session one. It would be interesting to see them debating against each other because that doesn't happen here. They're not focused, now listen to what he's saying and you tell me what your answer is to what he is saying. We don't have that. We have great big conferences opened by ministers where people say things and then it goes off into groups and it just becomes all obscured in position play but for a technical discussion, UN is very important for the region.
. The second session is on the economy and really I think Christina Quatec of ING Barings has distinguished herself as being rather more serious and thorough than any of the other economists. They talk vaguely about the terrible consequences, you can always slide around it. She's pinned it down, she's modelled, she's made estimates and she's way ahead of the game in terms of economists.
. The demographers are much of a muchness quite frankly. All our demographic forecasts have converged because they are basically all built on the insurance industry models, ASA 600 in its various updates. So there's nothing special about cohort component forecasts of population. I've done things, actually for that I've looked at not only the growth of the population and it's decline but also its distribution in the country which is almost more important because it shifts, the population shifts around under the impact of AIDS, you get more poor people in the poorer areas basically left to die, that kind of thing. So there's a session on the population implications.
. Then I think there has to be a session on prevention. That's where one needs to talk about risk awareness in the population because it's quite vital. There are various studies. Our little study is one, there are other studies on risk awareness and these should be presented first and then the ministry can come back and say whether or how they are responding. Now in my view their response is about 10% of the level of intensity it should be. This is a national crisis. We need a medical state of emergency. Every classroom in schools now has to become the focus of critical and the most urgent attention you could possibly have. In other words it has to be akin to the kind of attention you would give to an outbreak of poliomyelitis. Do you remember the panics in the old days with polio? There was far more worry and concern about polio than there is about AIDS. But let the minister talk about their agenda. The government is over-stressed.
POM. Where does social theory come in?
LS. Social theory?
POM. Where does the work of the two Australians come into it?
LS. All this business about well, tough one that, tough one. Very few people are prepared to be honest but where would it come in? I think there has to be an introductory session, the nature of the problem, not the size of the problem, the nature of the problem. An introductory session on the nature of the nature of the problem and then various papers around the socio-cultural impact on it, the interaction between the virus and all sorts of other things. So the nature of the problem, the size of the problem, the economic impact of the problem, prevention and the government's programme. That would occupy two days and make a lot of enemies.
POM. I'd do it in two sessions, one here and one abroad, mostly doing it abroad first because people are freer to talk. Obviously when they're here they'd be looking over each other's shoulders or whatever. The second thing I ask you, just to leave with you because I know you have to run, is that I have - and you may know that George Soros is interested in doing a project here on AIDS and that the Mandela Foundation has approached but for one reason or another he's not exactly keen on their ideas as being the only offer that could possibly be in the field. If you had to think larger in terms of saying, OK we're looking for an expenditure of maybe US$15 20 million, how would you think - ? One person suggested to me that what one might do would be to resurrect the structures of the National Peace Council and try to send that kind of thing all over the country, monitoring and information gathering. The structure already exists, it existed for violence, it didn't kill the violence but it had an impact on it and created a greater awareness of it. Would you just keep in mind what you might do?
LS. I'm not in favour of that. That was very necessary for the Peace Council and the peace process. Here one needs a much stronger central processing body which is completely independent of political influence, which is based on honest analysis in the various fields, more or less the fields that I outlined as my ideas for the conference. But that body needs to be equipped with the ability to reach out and provide, to empower local people to begin to act. But you can't have the inefficiencies. Look the Peace Council was in the end effective but it was very costly in effect. I know because I gave evidence and did studies for various aspects of it. We need a much more cost effective one needs to, for example, do incredibly thorough research on the most persuasive way of communicating with schoolchildren. We need to design a programme for implementation and you need to hire and train the people to go and implement it.
POM. Would there be value in a village or whatever and where there is an incidence of AIDS, you know there's an incidence, and what you do is you say, OK we will study this, we must bring people in who will train people, we will bring them in and we will put them into schools. If there are drugs available we will set things up so that monitors how people take their drugs. We will monitor these things over maybe an 18 month, two year period and see if this has an effect on the rate of incidence. We will have pantomimes like I've seen in Angola for landmines to teach children about landmines.
POM. They use pantomimes to teach them what not to do very effectively.
LS. Very effectively, yes.
POM. Would that kind of thing be worthwhile?
POM. Take one area, study it intensely, bring in the resources and see what impact the resources what outcome is there from the use of those resources.
LS. I agree completely. It's just that two years is too long a time lag. You need nine months.
POM. Nine months.
LS. Nine months you need to have at least your initial conclusions.
POM. If I asked you to help out on that?
LS. Yes, I think I can.
POM. What I will ask you to do is, I will publish it, if you talk about I'm doing this journal anyway which is separate, but if you do a paper which I have, you can almost do as a transcription you gave me, the things that are not talked about here, I'll publish them in the States in the journal that I edit and to send the journals back here. I've finished my research, OK? All they can do but that's the kind of thing I need, I think what needs to be done is this kind of explicitness to be actually spelt out in detail. I remember being in Lusaka and hearing a paper there on the impact of female circumcision and what that would do to a woman in terms of making her more susceptible and it was gruesome, the fear, but it had to be heard. Afterwards nobody would talk about it. They all sat there very tightly listening and afterwards rather than there being any kind of discussion, any questions from the floor, none. It was kind of get out and have a tea break.
. I'm particularly attracted to the idea of taking an area and saying, OK, in order to study this area you need to go through the steps almost as we went through to find the problem, to find that then look at the kind of people you have to bring in, go into it and the kind of training they have to have. I'd like to hear about drugs for example. I don't know who told me this but it's like having a drug, well I would think two things would happen: (a) is I'm HIV positive and I feel reasonably healthy and I get drugs and I say, hey I'm healthy, do you know what I will do with those drugs? I'll sell them. There must be a market out there for selling these things. I don't need them, I'll sell them. (b) Can people distinguish between colours the way we think they can, the different colours? In Xhosa the word the word for blue and green is the same. So what if you sent in thousands of pills and they were all blue or green, and you say two blue and three green, now you take three green and two blue at different hours of the day. Because they're all the same it doesn't matter whether you take the blue or the green.
LS. But that's an old trick. You take aspirins and you have a little mixture of dye and you simply immerse them and they absorb it and you bring them out and you hang them up to dry in the air and then you package them and you sell them as green pills. It's happens all the time. There's a massive industry here in phoney pills, only aspirins.
POM. How do you get beyond that? How do you take those things into account in your planning so that they don't happen? How do you anticipate the worst case scenario that this will happen, obviously they'll sell them, obviously they will die of AIDS. Can people tell the time of the day? To me and to you eight o'clock is eight o'clock, twelve o'clock is twelve o'clock, eight o'clock in the evening is eight o'clock in the evening. We have watches to tell the time, how do you do it if those things don't exist? How do you build a structure that allows you to get past it? That's the way my mind is operating.
. I have your address, I know I do, but I'll send you on the paper on your e-mail. I never thought that I'd begin with apartheid and end with AIDS, it's from A to A.