Two decades ago, we created a foundation focused on global health because we wanted to use the resources from Microsoft to improve as many lives as possible. Health is the bedrock of any thriving society. That fact has never been clearer than it has been over the last year, as the pandemic has upended lives in Africa and around the world.
African Lives Matter: The future crisis
Johannesburg scares the shit out of me. Here, even my Chicago core feels intimidated, not quite up to the challenge in this city where safety is the first priority. Forever on guard. Driving down a major thoroughfare you grow tense when you see a road-sign warning about a high-crime hot-spot. Hope to make it through without getting jacked or smash-and-grabbed.
The entire city feels on lockdown. Nowhere else in the world where you’ll see as many properties shielded behind high walls topped by electrified wiring. And signs boasting of “armed response” from private security companies. A city of gated communities where you might pass through a “boom” gate to enter into a neighborhood, then another security gate to gain access to an apartment complex. You live behind bars, gates on windows and doors. Those who live in free-standing houses keep dogs and guns. You take every precaution.
Breaking News: Burundi is the only African country without any case of coronavirus. When the Minister of Health was asked about the secret behind the zero case of COVID-19, this is what he had to say; “It is very simple. We don’t have the testing kits.
—Post on Social Media
For me that means avoiding Joburg proper and staying on the outskirts, mostly in the northern suburbs. In the city, you feel all eyes on you, a mark. I recall the afternoon I met some friends at the studio of a celebrated photographer on Constitution Hill. We had a great time. Good talk, good wine, good music. In a space made vibrant by cutting-edge photographs, paintings, and carvings. We stayed until the photographer closed up shop and secured his place for the night. Once outside, the photographer and my friends stood on the sidewalk and waited with me until my Uber arrived.
That’s Joburg, both the fear and the sense of connection, togetherness. What I love so much about this city, the edgy cosmopolitan vibe where you can do you in the company of the like-minded. Bungee jump in Soweto or meet friends for dinner and drinks in a trendy area like Maboneng, wine taste at the Butchery, browse bookshops, pop into a gallery or shop on Vilakazi Street, check out what the vendors are selling on the sidewalk. Hear some live music. All on the cheap.
These are among the many reasons why I have decided to leave America and make Joburg my home. Now there is this unexpected but additional benefit: observing from afar America’s misguided and doomed “re-opening,” I’m thankful to be here, in Joburg, thankful to be safe.
Ashley Walters – Assemble, 2011 from the series Dark City archival pigment ink on cotton paper. ashleywaltersstudio.comGiven the shortages this side, in America, my plan was to buy hand sanitizer once I arrived that side, in Johannesburg, but I discovered that, six days after the first confirmed case of COVID-19 in South Africa, no hand sanitizer was to be had, nor medical masks and gloves. It was Wednesday March 11, and the number of confirmed cases had increased to eight. Still, I felt little concern, focused instead on doing the things I needed to do, just another day, routine. Above all else—first things first—I needed a haircut, so I made my way to Fourways Mall, a ten-minute Uber ride from my apartment, found a barbershop, then slid into an empty chair at the direction of a slim man in his early thirties.
He draped an apron over me and secured it, asked me what I needed, and got to work, quick to make conversation over the low buzzing of his clipper. How was my day going? Where was I from?
During my many years of visiting the continent, my identity as an American often drew interesting responses. (During the Obama years, people on Zanzibar would chant the mantra, “Obama is good, Obama is fine.” Once in Nigeria, a man congratulated me.) The barber started praising Donald Trump, telling me that Trump is a great man doing great things for America, and speaking in a quick casual tone that assumed I agreed with these sentiments. I adjusted my body in the chair, causing it to swivel a bit. Changing the subject, I asked him where he was from—I couldn’t place his accent—how long he’d been living in South Africa, and how he liked it.
He told me he was from the Congo (DRC) and spoke about how tough life was back at home, war, no jobs, poverty, and how thankful he was to be living and working in South Africa—“a man should work hard and support his family”—even as he felt unwelcome.
“You know how it is when your brother doesn’t want you?”
I knew. I thought about an incident from a few months earlier. I’d had lunch (Japanese food) with a close friend, enjoying her company, our conversation continuing during our drive in her SUV to my apartment complex. She pulled up to the security gate and spoke in a local language to the middle-aged man inside the cubicle, only to have him answer her in English. She grew irritated. “That’s the thing about xenophobia,” she said.
That night, the electricity in my neighborhood went off in accordance with the “load-shedding” schedule meant to prevent long-term power outages across the country. The load-shedding plan loomed large in an ongoing corruption scandal. Eskom, the national power company, lacked the capital needed to make much-needed improvements to infrastructure since the previous administration had for a decade looted its revenues along with revenues from Telkom, the national telephone company.
The power would go off on five different occasions that first week in country, stirring up feelings of annoyance, frustration, anger—as one friend texted to me, “Welcome to our reality”—and disappointment. Mauritius and South Africa were the only two countries on the continent where I’d never had to put up with the usual commonplaces of underdevelopment. I sought out ways to overcome the limitations imposed on my daily schedule. Then, my seventh night in town, President Cyril Ramaphosa mandated that visitors from high-risk COVID-19 countries like myself had to report for testing. I was already scheduled to see my doctor later that week, so I waited out the three days to my appointment. I was welcomed into his office with a polite apology. We would not shake hands. I sat down at his desk. My doctor is a man of East Indian heritage, roughly my age, in his fifties, thoughtful and pleasant, and impressed by the fact that I’m a university professor. He checked my blood pressure. Not good. I’d been struggling to stay at safe levels, so he wrote a prescription for a new medication. He informed me that pharmaceutical companies often trial-tested new medications in South Africa that would later prove effective for African Americans given similarities in health conditions, a fact that would soon seem prophetic as the COVID crisis worsened in the US and black people started to die in high numbers.
As for my getting tested, he advised me not to. For starters, should the results come back positive my only option would be to self-isolate. More importantly, the country might need every test kit for the local population, no small matter. COVID-19 could devastate the country—a fear that I’d not heard voiced publicly—given that so much of the population suffered from chronic illnesses that would leave them vulnerable: obesity, diabetes, tuberculosis, hypertension, and HIV and AIDS. To make matters worse, residents in the villages have limited access to health care.
“Remember, you’re in Johannesburg,” he said, “which takes on the appearance of a First World country. But it’s nothing like many other parts of the country. The Third World.”
“A day or two later, I received word that the pastor had fallen gravely ill from a chronic heart ailment. At her funeral, I spoke to a doctor-in-training who’d visited her in the hospital. Her breathing was laboured, she gasped for air and needed to be put on oxygen, but the hospital only had three oxygen tanks, each already in use. Hoping to alleviate her suffering, the nurses improvised a futile remedy. They leaned over the pastor at her bedside and fanned air into her face.”
I like to get up early, 4 or 5 in the morning, make a pot of coffee, then start writing, my decades-long daily routine, but in response to the looming threat, I fell into the habit of also monitoring the news for a few hours each morning, a practice I usually avoid. I’d been in the country for less than two weeks when I came across a story that I took as a foretelling of things to come.
On March 24, Tawanda Makamba spoke to the Daily News Zimbabwe about the death of his thirty-year-old brother, journalist Zororo, at Wilkins Hospital in Harare the day before. In February, Zororo had gone on a twenty-day holiday to New York, returned to Harare on March 9, become sick three days later, only to have his general practitioner misdiagnose his symptoms as the common flu. “He was . . . told that he had a cough and a flu because in New York it’s cold and here it’s hot.” His health quickly deteriorated. “His doctor made it clear . . . that he had to be on a ventilator because he could not breathe. However, when we got at Wilkins Hospital there was no ventilator, no medication and even the oxygen they had to get it from the City of Harare.”
Sad but unsurprising facts.
For decades, the health system in Zimbabwe has been in decline like everything else in the country. Public hospitals often lack basics like running water and pain killers. Doctors wash and reuse bandages. When doctors and nurses strike for better wages, the government responds by firing them for violating their duties as civil servants. Given the scarcity of resources and professionals, Zimbabweans often travel to South Africa for medical treatment when they can.
The Makamba family managed to get a portable ventilator and medicine from South Africa. However, when they brought the ventilator to the hospital, “because the ventilator had an American plug, they told us to get an adapter . . . I then rushed to buy an adapter and came back . . . [but] they said they had no sockets in the room.” Compounding this absurdity, “I told them that I had an extension cord and pleaded with them to use the cord, but they refused.”
At some point, Health Minister Obadiah Moyo suggested Zororo be taken to the Borrowdale Trauma Centre, only for the owner of the center to call Tawanda. “[H]e told me that he could come and set up an ICU at Wilkins . . . complete with a ventilator and monitors, but he said that we had to pay US $120,000 . . . He added that once Zororo finishes using the equipment . . . we had to donate the equipment to Wilkins Hospital . . . [to] the government.”
Lacking money, the family could not agree to these terms. So Zororo remained put and suffered. “We had to phone from home, calling the nurse station to tell them that Zororo was in distress and that his oxygen was finished because they were not going to check on him. It even got to a point where they were telling us that we were bothering them.” The doctor would turn off his phone.
“At the end before he died, he kept telling us that he was alone and scared and the staff was refusing to help him to a point where he got up and tried to walk out and they were trying to restrain him.”
See similar tragedies, injustices, playing out each day across the African continent. Here is another.
Seven years ago, on the island of Zanzibar, I was visited one afternoon by a group of women, including a heavy-set pastor in her forties. A day or two later, I received word that the pastor had fallen gravely ill from a chronic heart ailment and had to be admitted to a public hospital. She died only five days after I’d seen her. At her funeral, I spoke to a doctor-in-training who’d visited her in the hospital. Her breathing was labored, she gasped for air and needed to be put on oxygen, but the hospital only had three oxygen tanks, each already in use. Hoping to alleviate her suffering, the nurses improvised a futile remedy. They leaned over the pastor at her bedside and fanned air into her face.
Across the continent, African lives don’t matter. Africans suffer. Africans die.
The dizzying facts: in 2015, around 1.6 million Africans died of malaria, tuberculosis and HIV-related illnesses, diseases that can be prevented or treated with proper access to medicines, vaccines, and other health services. However, less than 2 percent of drugs consumed in Africa are produced on the continent, making many people susceptible to the three big killer diseases. Africa accounts for 17 percent of the global population but half of the children in the world under five years of age who die of pneumonia, diarrhea, HIV, tuberculosis, malaria, and measles. Since the beginning of last year, the Democratic Republic of the Congo has seen the world’s largest and most deadly outbreak of measles. And then there are the classic diseases that claim many. The world’s most recent outbreaks of the plague were in Madagascar.