HIV and AIDS is mentioned by almost every narrator. A few older people seem uncertain of how widespread it is and are generally less well informed, but many narrators speak with understanding and compassion about people with the disease.
Arnaldo says the epidemic is widespread in Marracuene and that although various organisations provide food, information and testing facilities, drugs are in short supply. However, he says, “For me [practical help] is not enough; they should give moral support”. Antonio talks sensitively about discussions around stigma: “We were urged to treat [HIV-positive] people well… so that their hearts do not feel isolated.”
Arnaldo emphasises the links between poverty and vulnerability to infection, and is aware that being on a major transport route through Mozambique has been a factor in the epidemic’s spread in Marracuene. “Many girls get HIV and AIDS – because of poverty mainly… They get paid 10,000 or 20,000 meticais [from truck drivers] and in the end they get the virus.”
Pedro identifies another key factor in Marracuene: labour migration to Maputo and South Africa. Human traffic is two-way, as tourists increasingly come to Mozambique. Young girls take up with “a foreigner”, he says, because they believe “he will help me somehow to survive”.
Like others, Pedro is aware of the development cost of the epidemic: “we will have many HIV-positive people and… the government will have to stop development and assist the ill people and their parents.”
Other diseases mentioned are cholera, malaria and ndpswa or ‘the burning disease’, which appears to be a form of herpes and causes widespread suffering. There is general agreement among the narrators that the government has improved their lives by providing more health clinics. The problem for those from Mabalane is that nursing staff never stay long in post. They believe this might be because they live in the remote “bush”.
The lack of public transport means that the long journey to Mabalane hospital has to be made by foot, even by pregnant women. When the rains make the roads and rivers impassable, even this option is closed to the community. All this reinforces their sense of exclusion: “We are in poverty and totally forgotten,” says Maria.
Rafael believes people’s unwillingness to change can compound their health problems, citing the example of a cholera outbreak when, despite receiving plenty of information about risk factors, “certain families would not change, even after all these warnings and thus many lives were lost”. He fears the same thing is happening with HIV.