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A Mozambican boy passes AIDS graffiti outside a building in Maputo, in this Dec. 1, 2001 file pho

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Philile Ntuli, a student at the University of KwaZulu-Natal, Pietermaritzburg, holds a photo of h

PIETERMARITZBURG, South Africa—Philile Ntuli sees the effects of HIV/AIDS every time she goes home.

A third-year English and politics student at the University of KwaZulu-Natal in Pietermaritzburg, Ntuli is a resident of Clermont, a township near the port city of Durban. She says almost every week in Clermont there is at least one funeral for someone who has died of AIDS.

“I know I’m going to get a phone call saying so-and-so passed away, and I know it’s AIDS,” she said.

Ntuli lost her seven year-old niece in mid-October to the illness. Two weeks later, one of her many sisters died from it. Ntuli has more family members than she can count, and she predicts 80 percent of them are HIV positive.

“When you know that 80 percent of your family is infected, and your friends, the people you grew up with, it’s like your past is slowly disappearing,” she said.

There are millions of people like Ntuli in South Africa, people whose lives have been affected in some way by HIV/AIDS. Even though South Africa is one of the most developed countries in Africa, it also faces one of the biggest AIDS crises in the world.

The United Nations has estimated that at the end of 2003, 21.5 percent of adults in South Africa were HIV positive. Last year, an estimated 370,000 people died of AIDS in this country.

It is the nightmare that will not leave the country alone. According to some doctors, there are an estimated 1,700 new HIV infections in South Africa every day.

Statistics like that can boggle the mind, but Ntuli knows how close they hit home.

“When almost everyone around you has AIDS, you ask yourself, ‘What’s going to happen? Who’s going to be here in five years?’” she said.

University officials say there are no statistics of the HIV/AIDS infection rate among the student body at the Pietermaritzburg campus because no one has done a comprehensive survey.

But according to the campus AIDS Program, a study undertaken in 1999 projected 14 percent of the student body would be HIV positive in 2004, which is the figure the campus uses for planning purposes.

The fact that many university students are away from home for the first time and more prone to experimentation with sex and drugs can make them susceptible to HIV/AIDS.

But students are also generally more educated about the epidemic as well, says Emily Mabusela, the coordinator of the campus HIV/AIDS support unit, which coordinates programs that deal with HIV/AIDS.

Mabusela estimates that the infection rate among the student body probably mirrors the infection rate in the rest of South Africa.

“It shouldn’t be any less,” she said. “A lot of people would like to think it’s less, I don’t know why.”

But Mabusela also points out that at the rate the virus is spreading, the most pressing concern isn’t how many people are infected, but rather how they should cope with it.

“The question they ask is: if there is an elephant in your house, do you ask how big he is, or do you ask how to get him out?” she said.

When asked whether she knew anyone who had died of AIDS, she shrugged.

“It’s hard not to,” she said.

* * *

Sit down in the waiting room of the university health clinic and you see signs of how heavily HIV/AIDS weighs on minds here.

On the whitewashed wall next to the receptionist desk, flyers taped there declare that HIV Voluntary Counselling and Testing will not be given during finals. Across the room there is a condom dispenser. Walk down the hallway and you come across huge diagrams that look like they’re straight out of a biology textbook which show how HIV/AIDS infects the body.

Through a door to the right just outside the waiting room is the office of Sister Rose Meyer, the campus HIV/AIDS counsellor. It is cool inside, even though outside it is a balmy summer day. Meyer is all smiles and seems almost grandmotherly – a good thing because she does a lot of comforting in this office.

It is here that one of South Africa’s countless battles against AIDS is fought on a daily basis.

A trained nurse, Meyer does all the HIV/AIDS testing for the over 8,000 students and staff at UKZN, Pietermaritzburg. She is always there when students finds out whether they are HIV positive.

“I’m disclosure one,” she said while sitting in one of her office’s comfortable chairs.

Meyer pulls a bucket stamped with biohazard symbols out from under her desk. This is where she stores used needles and test strips. “You don’t want to reach in there,” she remarks as she fishes about inside with a pair of tongs and pulls out a test strip of a student who tested negative and one who tested positive.

She describes how she administers voluntary counseling and testing: students must book appointments in advance. She talks with them beforehand, educating them about the virus and asking them if they are sure they are ready.

If they answer yes, she administers the test, a pin-prick that draws a drop of blood which she tests for signs of HIV antibodies. It takes 10 minutes to get the results.

Students always have a chance to leave before those 10 minutes are up.

“One student, he left and didn’t ever come back,” she remembers.

Meyer always reads the results with the student. If a student tests positive, she does two follow-up tests to be certain of the results.

The ones who test negative cry more than the ones who test positive, out of sheer relief. Those who test positive usually go through a process Meyer likens to “shell-shock”: they’re fine the day of the test, but it’s the day after when they need support.

“The next day they come with their fears and worries, because you could imagine they’ve had all night to think about it,” she said.

For those who test positive, Meyer takes on the role of counselor and psychologist. She advises them on their eating habits, how to spend their free time, how to break the news to their family. She can see a student who has recently tested positive three to five times a month, and sees all her HIV-positive students at least once a month.

She urges students who are HIV-positive to continue pursuing their degrees, even though they are planning for a future that may never come.

With a degree, they can get higher-paying jobs out of college and afford HIV treatment when it becomes necessary.

She also monitors their blood cell count and can recommend antiretroviral treatment if it slips too low.

The hardest time for her, she says, is when the blood cell counts come back for the first time, because then she can see the student calculate how long they have left to live – and possibly work out who infected them.

“And even though they say: ‘It doesn’t matter, I have to move forward,’ I think it does matter,” she said.

“It’s exhausting ... emotionally exhausting. But it’s rewarding. I always say to the student, ‘I cannot hold the burden with you, but I’m walking your path with you, I’ll hold your hand for the duration.’”

“They need to know I’m just a crutch,” she adds.

The number of students who test HIV-positive on campus is “incredibly low,” in Meyer’s words. Last year, out of all the students who underwent an HIV test at all five UKZN campuses, only 6 percent tested positive.

But this does not include students who are tested off campus, or students who don’t get tested at all.

“By virtue of the fact that we have the most sexually-active age group on campus, it has to be higher than 6 percent,” Meyer said.

Not a five minute walk from Meyer’s office is another front in the war on AIDS. From her office on the top floor of the student union, Mabusela runs projects on campus about HIV/AIDS and does outreach to the Pietermaritzburg community.

Recently, students helped repaint an orphanage and brought in new furniture as one of their outreach projects.

“It looks like a new home,” she said, smiling. “You can’t change the plight those kids have gone through, but you can change the current environment.”

Whether students who work for her program are HIV positive is not Mabusela’s concern. Rather, she’s interested in creating a comfortable environment where students can talk about the virus.

On a good day, she says, up to 40 students can fill up their lounge area. They are usually students of color.

In a country as racially-divided in South Africa, it is almost inevitable that fear of the HIV/AIDS would have racist overtones.

The poor and uneducated are usually the most vulnerable to HIV/AIDS, and because the vast majority of South Africa’s poor are black, there is a perception that HIV/AIDS is a black disease.

Some rumors that circulate about the virus have racist connotations, for example, that you can get AIDS from kissing a black person.

In the townships – generally poor, rural communities where primarily black people live – AIDS is the worst. In Ntuli’s township of Clermont, she estimates that among people between 15 and 25 years old, 60 to 70 percent of them are HIV-positive.

Mabusela says the myth that AIDS is a black disease largely stems from media coverage in South Africa. She says when white people have AIDS, they can afford to go to private clinics that keep the media out. But poor blacks who have AIDS have to go to public hospitals where lines can number in the hundreds.

“HIV/AIDS is one of the ways where the socio-economic conditions of our country and its history show itself,” Mabusela said. “It’s been painted black because black people are accessible to the media.”

No one has an answer as to what can be done to stem the tide of the epidemic. Both Meyer and Mabusela agree that the country’s HIV/AIDS crisis is getting worse.

The South African government’s response to HIV/AIDS has been criticized as lackluster, particularly since President Thabo Mbeki questioned for a time whether HIV does, in fact, cause AIDS.

Social factors, such as having multiple sexual partners, and South Africa’s high number of rapes, have spread the virus so fast that people don’t talk much about stopping it anymore. Rather, they just continue fighting.

That is what Ntuli will do, and she keeps a photo of her seven year-old niece on her table as a reminder. “That drives me, it just makes me want to push harder,” she said.

One year from graduation, Ntuli has high ambitions for a career in politics, and she hopes of one day returning to Clermont to help people improve their situation.

“Those who do get out (of the townships) are seriously blessed,” she said. “And those who do get out have an obligation to go back and say, ‘I just got out clean. So what do I need to do now to get my brothers and sisters out?’”

For decades, South Africa was defined by the fight against apartheid.

Now, today’s youth may very well be defined by a different fight – the fight against HIV/AIDS.

“It’s our current struggle,” Mabusela said. “We struggled to get liberation for this country (from apartheid.) The struggle continues now to fight the disease.”