It’s a job for heroes. The doctors and nurses in South Africa who work with HIV-infected patients fight on the front lines of the worst epidemic in recorded history. Some forty-five million people worldwide are infected, and in South Africa nearly five million people live with the disease?more than 11 percent of the population. Over the past year, Professor Gerald Oppenheimer, Health and Nutrition Sciences, and Ronald Bayer, a colleague from Columbia University made three extended trips to this devastated country, interviewing ninety doctors and nurses involved in the epidemic.

        Oppenheimer and Bayer have studied the effects of HIV/AIDS since 1983. Their book AIDS Doctors: Voices from the Epidemic (2000), narrated a history of the HIV epidemic in the United States from the perspective of physicians. In South Africa a small epidemic occurred among the gay population in the 1980s, but HIV became a staggering health crisis there in the early 1990s. While other African countries were becoming infected, the international sanctions against South Africa’s apartheid state had slowed the transmission of HIV across its borders. After the embargoes were lifted and the political scene shifted, truck drivers from the north joined migrant workers and returning exiles to spread HIV rapidly through the population. By 1994, when Nelson Mandela was elected president, AIDS was growing explosively. “In South Africa, the epidemic began at the moment of greatest hope for the country,” reflects Oppenheimer.

        Black South Africans are suffering the greatest number of cases. Families are devastated and hundred of thousands of children have become orphans. As Oppenheimer and Bayer have learned, the chronically underfunded public medical sector is reeling from the number of cases requiring attention. Unfortunately, too many clinicians in both the public and private health sectors are convinced that AIDS is a hopeless, fatal disease. Those interviewed reported that patients with HIV are often denied needed medical care. The reluctance of the postapartheid government to support life-extending anti-retroviral medications for patients in the public sector has increased the sense of helplessness, even among the minority of doctors who have become AIDS specialists.

         “What is remarkable in South Africa is the story of those who remain dedicated to resolving the medical, psychological, and, ultimately, the political problems of AIDS,” says Oppenheimer. “Some of these doctors and nurses are depressed or burnt out, but the majority endure. We want to know what keeps them going.”