Following the recent visit to Constitutional Hill in Johannesburg, I sat wondering how so many years have passed and yet so little has changed. The violence, overcrowding, poor sanitation, and diseases found at Number Four were not contained within the walls of the prison. Though the doors of Number Four officially closed in 1983, these horrific health hazards have continued to spread across South Africa into townships and city streets, still plaguing this nation today. This prison carries the scars of this nation, both metaphorically and literally, as seen in the carvings on the back of cell doors, and in stories from men incarcerated as they painfully remember their suffering. This historic site reminds people like myself that these scars have yet to fully heal, and there are some wounds so deep that the bleeding has yet to be stopped.
At the heart of infection prevention lies effective waste management–something that Number Four sufficiently lacked. When our group of about thirty people filed into one of the communal cells, we almost filled the concrete box, while maintaining comfortable personal space. The same cannot be said for the 60 to 90 men that spent their days crammed in each of these cells. In fact, communal cells housed double what they were designed for. Inmate numbers escalated during apartheid, with the volume of political prisoners increasing with each rising of the sun. Behind the bolted doors, a highly organized hierarchical system existed in the cells—one that an outsider might never know existed. There were gang bosses who controlled the status and lives of all of those living in that cell. In fact, inmates would sell new prisoners to the gang bosses for sex in order to get a sleeping space further away from the sanitation bucket. The facility itself was a health hazard, yet the actions of the inmates within the prison amplified the unsanitary and unsafe life conditions.
Unfortunately, this was not the first instance while in South Africa where we have seen this type of situation. Rewinding to Cape Town, driving into Khayelitsha Township, disembarking from the bus, being swallowed by an eager and excited crowd of school children, and working with the Call to Serve foundation to feed the hungry mouths of these children. Amidst this chaos, appeared a young disabled woman ravenously searching for any scrap of food the dirty ground could provide her. I kept an eye on her the entire morning hoping some type of caregiver or guardian would emerge by her side, but all that I remember seeing was a poor woman nourishing her body with filth covered hot dog bun scraps off of the ground. As I stood in front of a quote at Number Four, I was immediately taken back to that moment in the township. This was a quote from Khehla Shubane, a political prisoner, and read: “You stay away from the food until hunger starts pushing you towards eating it. And once you are sufficiently hungry, the food is okay.” Forty years later and this quote still rings true for so many here in South Africa. Khehla Shubane was a prisoner in a corrupt jail, whereas this disabled woman lives in a free, democratic world, yet she is shackled by her situation and the society she was born into.
I am disgusted that this is the case. Though the woman I previously spoke about was eventually given some of the untouched leftover food, this was only a temporary filler for the pit in both her stomach and unjust reality.
The issues with sanitation and hygiene extend far beyond nutrition and the consumption of filthy foods. A gap in proper hygiene and health education leaves people vulnerable to a host of other dangers. That same day in the township, there was a young girl sitting and waiting patiently to receive her lunch meal. She wore a pair of purple, patterned pajamas sitting criss-cross, exposing her bare, muddy feet. When I arrived at her side and bent down to give her the last piece of her meal, she politely thanked me for her hot dog and rose to return to her family. However, as she turned around, I noticed a dark red stain on the back of her pants. Being a female myself, I realized this stain was blood from menstruation. Though I am only an outsider looking in and it would be naïve of me to draw conclusions about her specific situation, it saddened me to think that such young girls are vulnerable to the sexual assault and rape that I have read much about. As I looked around at all of these young girls, I questioned how many of them live in fear of sexual assault due to their post-pubescent statuses being unnecessarily exposed because of a lack in feminine hygiene products.
A political prisoner by the name of Molefe Makiti at Number Four was quoted on a sign I viewed saying, “The biggest thing in prison is sex. The way that the cell bosses would entice young men to have sex with them was by giving them better food.” The parallel between sexual assault in this prison years ago and in the townships across South Africa currently cannot be overlooked. Inmates were subjected to unthinkable indignities, both by prison authorities and gang bosses. Today, so many young girls are defenseless against sexually transmitted disease, pregnancy and unwelcome sexual acts, carried out by older men and other adolescents alike.
Katharine Wood and Rachel Jewkes wrote extensively about their research with pregnant teenagers in an African township in their paper titled: “Violence, rape, and sexual coercion: everyday love in a South African township”. These authors addressed the idea of love and what that meant to so many young girls. In most cases, love falsely correlated to penetrative intercourse in their minds. In fact, some men explained that the purpose of love was sex, and people in love must have sex as often as possible. As if reading that did not sicken me enough, Wood and Jewkes went on to quote the language of girls: “he made me”, “he just pushed me and overcame me”, “he forced himself onto me”, “he did as he wanted with me”, “what could I do?” (Wood & Jewkes, 1997). These heartbreaking statements show the severity of assault in adolescent relationships in townships. The effects of sexual assault and rape affect the mind, body, and spirit, as they are not mutually exclusive. This type of assault often leads to unwanted diseases, perpetuating the ever-present HIV/AIDS epidemic here in South Africa, as well. It is a complex form of trauma affecting health that no young boy or girl, or grown man or woman should ever have to experience.
Health truly encompasses all facets of life, making it a determinant of so much in a person’s life. I am a believer that health is more than just a physical feeling of goodness, but instead a compilation of physical, emotional, and mental well-being. As I continue to reflect on my time spent at Constitutional Hill, I find more and more connective paths to other impactful moments from my time spent in this country. Unfortunately, most of these connections bring to light a tremendous amount of health issues in South Africa—health issues that should have been left on the other side of the closed doors of Number Four.
Wood, K., & Jewkes, R. (1997). Violence, rape, and sexual coercion: everyday love in a South African township. Gender and Development, 5(2), 41-46. doi:10.1080/741922353