From the virus frontline, doctors recall battling S Africa’s HIV outbreak

CAPE TOWN: A deadly virus was ravaging South Africa when Belgian doctor Eric Goemaere first set foot in Cape Town's sprawling Khayelitsha township on a chilly southern hemisphere winter of 1999.

By then HIV had infected more than 5.6 million South Africans, causing thousands of deaths from acquired immunodeficiency syndrome (AIDS) -- for which there is still no cure. "There was a traffic jam every day at the cemetary," Goemaere recalled.

"People were dying like flies... There was no accessible treatment so the sick simply went to church." Two decades later, Goemaere and his colleagues at Doctors Without Borders (MSF) found themselves on the frontline of another epidemic. Cape Town's Western Cape province is now home to over 65 percent of South Africa´s 27,403 confirmed coronavirus cases.

The coastal city has been pin-pointed as a "hotspot" of the novel respiratory disease and Khayelitsha has not been spared. "The number of people infected in the community is picking up rapidly," said Goemaere, who is now coordinating the opening of a 65-bed field hospital for COVID-19 patients in the township.

After years spent fighting the spread of HIV in impoverished overcrowded settlements, veteran health workers like Goemaere are offering valuable insight for South Africa´s coronavirus response.

"We are still trying to bring the treatment close to where the problem is," said Goemaere. "But this time we were much faster in involving the community." HIV was a murky matter in 1999 Khayelitsha.

While dozens succumbed to AIDS on a daily basis, treatment was only available in faraway hospitals at a steep $11,000 (9,876 euros) per year. Local clinics were highly suspicious of doctors from the outside. "The nurses said: don´t come here, we are all going to get infected," Goemaere said, remembering his first day on the field.

"In fact, the majority of cases in the waiting room were already infected, but there was no one testing so they didn´t realise the danger." AIDS, like coronavirus, was initially perceived as a foreign disease imported from richer countries.

Once it spread through the township, it was widely associated to homosexuality and prostitution. In the early 2000s, activists such as MSF nurse Nompumelelo Mantangana started touring Khayelitsha with "I am HIV positive" t-shirts to tackle stigma.

"The problem we picked up with COVID-19 this time is the belief that white people are the ones importing the virus," Mantangana said. "We had to go back and work with the communities," she explained. "Once again our foot soldiers... are going door to door, giving out pamphlets and explaining what COVID is."