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Remembering Mandela

Bill Gates Sr., Nelson Mandela and Jimmy Carter at Zola Clinic in Soweto, South Africa (March 7, 2002) Credit: Photo: Getty

Editor's note: Nelson Mandela died Thursday. This story was originally published on Saturday to mark World AIDS Day.

I missed two opportunities to meet Nelson Mandela, but I did make myself comfortable once in his favorite chair.

In 2001, I visited Mandela's personal office in a residential neighborhood of Johannesburg. I was there to plan with his staff the visit of Bill Gates Sr. and former President Jimmy Carter. I was working at the time with the Bill & Melinda Gates Foundation.

HIV/AIDS prevention was, as it remains today, a priority for the Gates Foundation. In 2001, just two years after Mandela left office, his successor was refusing to recognize the danger of the disease that was suddenly wracking his country. My job was to help prepare the way for Gates and Carter, who would in a few months visit the heads of three African countries: South Africa, Nigeria and Kenya. They hoped to pressure the leaders to take bolder action on AIDS prevention. Mandela would join them on the South African leg of the mission.

On a hot, sunny afternoon Mandela’s foundation staff ushered me and the rest of the advance team into a spacious office, well-appointed with pristine white furniture and wooden bookshelves. I sat down in a comfortable armchair and we began to discuss the upcoming visit. As we were wrapping things up I soaked in the importance of the room and asked a staffer where Mr. Mandela preferred to sit.

“You are sitting in his chair,” she told me with a smile.

I bolted straight out of the chair as if I had accidentally sat on the throne of Zeus. I was certainly not worthy to sit in such a man’s chair.

Sunday is World AIDS Day, and Nelson Mandela’s much-publicized health struggle in South Africa has put me in a reflective mood. Imprisoned around the time I was born in the early 1960s, Mandela has loomed large throughout my life. I recall the anti-apartheid protests during my college years in the 1980s, and then the first time I missed meeting him in person: when he and his wife, Graca Michel, visited Seattle in 1999. A former colleague at the Gates foundation, Trevor Neilson, remembered that visit a few months ago on HuffPost.

One of Mandela’s colorful South African shirts has graced the walls of the Gates Foundation’s offices since he gave it as a gift those many years ago.

As the world watched Mandela’s decline earlier this year, I decided to dust off an old diary entry I had written during my trip to South Africa 12 years ago. I offer it here as a woefully inadequate remembrance of a man whose message of bold, courageous leadership in the face of unspeakable oppression resonates on this World AIDS Day from the Cape of Africa to the Pacific Northwest.

The airplane rises from lush Kenyan jungles and levels off as the terrain below pales from bright green to sandy beige. There is nothing below. The cities, roads and agricultural plots of land so common on  a trans-American flight are not to be found. Hours later, however, those things begin to appear — development and South Africa. 

Compared with other cities in Africa, Johannesburg is remarkable for its relative wealth and sophistication. My hotel adjoined a large, modern shopping mall. There was even a faux Italian village where young professionals had their pick of cuisines. Think U Village. 

After checking into the hotel we boarded a van and traveled through lush neighborhoods onto a large highway and in a short time were dumped onto the narrow, dusty streets of Soweto, the spiritual and political center of the anti-apartheid movement. 

My job was to help scout locations where Mr. Mandela would join Carter and Gates to send a strong message to all citizens of South Africa (especially its new and out of touch president) about the AIDS crisis. Someone had to. Where better to commence that strong message than here?

Into Soweto

Baragwanah Hospital is a large, modern facility in Soweto. During my delegation’s visit, we were joined by a sprightly medical doctor named Jim McIntyre, director of the Perinatal HIV Research Unit. Like the rest of his team, Jim is smart, hard-working and passionate. The team also is good-humored. Such a demeanor may explain why they can stick with it as long as they have in the face of such adversity. About 70,000 children in South Africa are infected every year. Dr. McIntyre and his team are trying to save them by helping their mothers prevent infection or transmission of the disease during birth.

We were invited to join a group of young mothers who gathered in a sunny room on the hospital’s main floor. This was an HIV/AIDS support group for mothers and their babies.

Everyone seemed happy and sang beautifully to the babies who sat on their mothers’ laps. These women, unlike so many others in South Africa, received Neverapine, a drug that can prevent transmission of the virus to their babies. We joined in the singing and were invited to hold some of the babies, which we gladly did.

As the singing ended, one mother walked up to me and quietly asked my advice for how she should go about talking with her family about the fact that she had HIV/AIDS. I had not been introduced and so she must have taken me for one of the doctors. A cousin of mine had died of AIDS, but the disease had always felt removed from me until that moment. Here was a woman who needed help. She was standing right in front of me with fearful eyes, asking what she should do. She began to cry, and suddenly I felt more useless than at any time in my life.

At the time of my visit, half a million South African kids under age 15 had lost one or more parents to HIV/AIDS. Yet, for $4 per dose, Neverapine could greatly reduce the likelihood of HIV-positive mothers in this community passing a deadly virus along to their babies. At $4 per dose, prevention sounds wonderful until you realize that most sub-Saharan Africans live on less than $1 per day. Economics aside, the South African government was denying the distribution of the drug for various complex reasons.

We left the hospital and drove to the Zola Clinic. Here, Mandela, Carter and Gates would call on South African President Thabo Mbeki to treat HIV/AIDS with the same energy that he had used to fight apartheid. The clinic was located just down the street from one of the high schools where anti-apartheid riots had broken out in 1976.  Back then, young black people took to the streets chanting, “Power, Power, Power.” 

More than 30 years after those riots, Black South Africans have greater political power. But I was struck that day by a power that they did not have: the power over their own health. HIV/AIDS had ravaged this community just as apartheid once did.

Young pregnant mothers arrived at the Zola Clinic looking for counseling and HIV/AIDS testing. Shaded from the sweltering South African sun and the critical eyes of their community, these women enter small rooms to learn the results of blood tests taken just 15 minutes earlier. They are escorted into these rooms by other young women who volunteer there as testers and counselors. These volunteer counselors, sadly, entered these rooms themselves not long ago and emerged with the knowledge that they, too, had become HIV-positive. Now they have devoted themselves to helping others in this clinic.

For most of the young patients, these are quiet, anxious moments. They walk into the counseling room and sit on a wooden stool.  Soon they will learn that they are infected with HIV. Soon they must confront not only their own fate but the fate of their unborn child. Then there is the often unbearable stigma their families, lovers and communities will attach to their names and faces. They are poor, uneducated and unemployed. Now they have HIV.

As I walked through the clinic, I discovered one of many ordinary-looking, care-worn ledgers sitting on a countertop. I opened one of these thick books of medical records. I am certain that anyone who watched me would have seen my eyes widen and then close as sadness and grief overwhelmed me. Here, beyond the news headlines are the most human stories, the truest stories of HIV/AIDS in South Africa. With painstaking care and detail, volunteers have written down what it is like to tell these mothers-to-be that they are infected. “Your test is positive. You have HIV.”

According to the stories in the ledger, one pregnant mother looks down and begins to cry. Another worries that if anyone in her community learns about the test results she will be asked to leave. Every mother fears that their unborn child will be orphaned.

The brief synopses of their conversations are written at the end of columns of data — data that ultimately add up to the mind-numbing HIV/AIDS statistics we hear and read each day. It was clear from their painstaking penmanship that these volunteers had labored to create a precise report — to be read by whom I do not know.

The greatest shock occurred when I discovered a nearby storage room filled with these ledgers. The ledgers run on for page after page, book after book.  Thousands of entries, hundreds of books, piled in room after room after room. Together they add up to the mind-numbing statistics of the global HIV/AIDS crisis.

Remember for a moment what it felt like the first time you stood at the base of the Vietnam War Memorial and took in the enormity of the names carved into that black polished wall, nothing but your own face reflected back at you. It was the same effect.

The goal of the Gates, Carter and Mandela events in South Africa was to put pressure on then-President Thabo Mbeki, who bizarely failed to recognize the significance of the spread of HIV in his country. Prior to the trip, Mandela had been reluctant to criticize his successor publicly. 

"It is never my custom to use words lightly," said the Nobel laureate and former head of state. "If 27 years in prison and 27 years of silence in solitude have taught me anything, it is how precious words are! Wasting words and energy in worthless ridicule distracts us from our main course of action, which must be not only to develop an AIDS vaccine, but also to love, care for and comfort those who are dying of HIV/AIDS."

Mandela was the picture of health and determination that March day in 2001. With Carter and Gates, both grandfathers like him, at his side, Mandela did speak truth to power from that clinic in Soweto.

Since then, there have been improvements worldwide thanks to increased awareness, treatment and research progress, but prevention and treatment of HIV/AIDS remains urgent. The WHO  and UNAIDS estimate that 35.3 million people were living with HIV at the end of 2012. The CDC estimates that approximately 50,000 people become newly infected with HIV each year and 1.1 million people are living with HIV — but one in five of them are not aware that they are infected. 

Mr. Mandela was discharged from the hospital in September after wide speculation that he was on his death bed. As a new film about his life begins this month in theaters — A Long Walk to Freedom — the world has watched with great sorrow and admiration his long farewell.

On this World AIDS Day, learn more about the disease and consider making a contribution.

Disclosure: Crosscut receives some of its funding from the Gates Foundation.

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