1. How AIDS Kills
By Bhekisisa Mncube
Book Title: Letting Them Die
Author: Professor Catherine Campbell, London School of Economics &
Political Science
Publisher: The International African Institute in association with James
Carrey, Oxford
How Aids Kills?
'Letting them Die' is about the construction of sexuality by migrant mineworkers, commercial
sex workers and young people in the South African mining town of Summertime in
Johannesburg. It is a valuable study of the Summertime HIV/AIDS Project, and it reveals why
HIV/Aids intervention programmes often fail.
The book is a result of seven years of collaborative research including monitoring and
evaluation of a multi-million rands HIV/AIDS campaign based in Summertime, one of the worst
affected mining towns in South Africa. The book highlights the barriers and constraints in
controlling and managing the AIDS pandemic.
Summertime is home to 170 000 predominantly black African people. About 70 000 of these
are migrant mineworkers who dig gold for a living. These workers are housed in single-sex
hostels, which sometimes have as many as 12 or 18 men in a room - this offers no privacy and
scant opportunities for intimate relationships. It is these men, the book suggest that gave birth
to a thriving commercial sex trade. It reveals that women find accommodation in informal
shack settlements on the mine perimeters from where they sell sex and alcohol to the miners.
Some women, the study found also sell sex in the open fields surrounding the mine fence.
The Summertime Project sought to limit HIV-transmission through three activities: Sexual
Transmitted Infection (STI) control; community-led peer education and condom distribution;
and, local multi-stakeholder collaborative project management.
The book seeks and succeeds in answering the following key questions:
• Why do people knowingly engage in sexual behavior that could lead to a slow and
painful premature death?
• Why do the best intentioned attempts to stem the tide of the epidemic often have so
little impact?
2. The book plays special attention to the phenomenon of sexuality, and the way it is shaped and
constrained by an avalanche of factors. These range from the deepest psychological needs for
intimacy and pleasure, to the complex and unequal relationships between women and men,
rich and poor.
The books central argument is that AIDS is a social problem that is embedded in uneven
development, and to address it requires multi-pronged strategies including stakeholder
collaboration. The book suggests that the solution to the AIDS crises lies beyond the bio-
medical approach. It says the one vital strategy for reducing HIV-transmission in Summertime
or anywhere in South Africa would be to reduce the social inequalities that undermine the life
chances of so many people. Author, Professor Catherine Campbell maps a link between chronic
unemployment, poverty and housing shortages - and how these have become entangled with
the ideas about masculinity, love and sex thus creating an economy of exchange that
perpetuates the transmission of HIV/AIDS.
The study found that sexualities are constructed and reconstructed at the intersection of a
kaleidoscopic array of interlocking multi-level processes, ranging from the intra-psychological to
the macro-social. After conducting many interviews and surveys with the Summertime
residents in the three categories - mineworkers, commercial sex workers and youth, Campbell,
concludes that the driver of the epidemic is linked to the innermost needs for trust and
intimacy. These are symbolized by the closeness of the flesh-flesh sex.
Several surveys and focus groups conducted with mineworkers and other informants revealed
shocking results - these men have high levels of HIV/AIDS awareness, and yet they refuse to
wear condoms. It is these condom forsaking men who drive the spread of the epidemic. Some
miners opined that there is nothing more risky than going underground to dig for gold in return
for a pittance. In their warped view of reality, the risk posed by AIDS pale into insignificance in
relation to their full-time profession. On the other hand commercial sex workers did not always
insist on condoms because they don't want to alienate their regular clients. Some claimed that
threats of or real violence was the main driver for their condom forsaking behaviour.
The study concludes that in this mining town, AIDS will kill six out of ten young women and four
out of ten young men.
Letting them Die is sad book that documents the voices of real people who knowingly engage in
sexual behaviour that could lead to a slow and painful premature death. It sadly shows that
even the best intentioned programmes such as the Summertime Project are susceptible to
failure unless the government addresses the fundamental causes of inequalities between men
and women, and rich and poor among others.
