When Dr Eric Goemaere, medical coordinator of Médecins Sans Frontières (MSF) in South Africa, embarked on an ambitious project to test the feasibility of antiretroviral treatment (ART) in Khayelitsha in 2000, South Africa’s denialist position on HIV-Aids was so unshakeable that the programme almost had to be carried out in secret.
“At that time, there was a lot of opposition to what we were doing,” Dr Goemaere revealed during his address to hundreds of University of the Third Age (U3A) delegates at the Baxter Theatre last week.
“We had partnered with Zackie Achmat’s Treatment Action Campaign on the project, but we were asked to be discreet.
When I first arrived in South Africa in 1999, I set up a simple intervention to reduce the transfer of HIV from mother to child in Alexandria township (Johannesburg). But when I met with government officials to tell them about the project, after five minutes I was asked whether I could do the intervention without ART.”
Despite the prevailing political mindset, Dr Goemaere and his team forged ahead in Khayelitsha. Faster than even they could have imagined, the project began to yield results.
“After much deliberation, we asked UCT to publish the results on ART to show the feasibility of providing it in a poor area. The key moment came in December 2002, when Nelson Mandela visited the Khayelitsha clinics.
“We knew that if we could get him to wear one of our ‘HIV-positive’ T-shirts, it would make a huge political statement.
“Without a second thought, he removed his famous Madiba shirt and put on the T-shirt. That image was sent around the world. It changed policies towards ART.
“It was the best day of my life.”
And what a life it has been for the MSF veteran, who is now based at the organisation’s offices in Mowbray after taking up residence as a South African citizen in Sea Point.
For 35 years he has traversed the globe saving lives in areas stricken by conflict, famine and disease, and is among MSF’s most senior members.
The international organisation was only eight years old when a young Dr Goemaere made his first tour as a volunteer in 1979, a hellish baptism of fire in Cambodia involving 250 000 refugees fleeing the brutality of the Pol Pot regime.
As chaotic scenes played out at the Thai border, it became clear that if MSF was to provide care to the ill and destitute, logistics would have to be improved tenfold.
“My first experience as doctor was in Chad a few years later. I was just a normal GP, but in Chad I had to become a war surgeon on the spot. There was already famine, and then Libya invaded Chad. That was how it was at that time.”
The Ethiopian famine of the mid-80s, he said, proved to be an education, as MSF began to understand how even best-intentioned humanitarian aid could be exploited for political gain. “Trucks came in the middle of the night to take people away, people who were dying. We also spoke out against the hijacking of humanitarian aid, and we were expelled.”
The MSF found that there was a political and ideological motivation behind the transfers, carried out with the twofold aim of weakening the guerrilla movements in the north by removing their grassroots supporters and of putting these populations in villages in order to bring them ideologically in line with government policy.
Since the 1990s, Dr Goemaere has aided victims in most of the world’s conflict zones, from Bosnia to Syria, while also assisting in natural disaster areas like Indonesia following the 2004 tsunami and Haiti after the earthquake in 2010. “The Haitian earthquake was where our logistics came to the fore.
In 48 hours we established a fully-functioning hospital, and within a month we had performed more than 3 000 surgeries.”
With Dr Goemaere now calling South Africa home, it stands to reason that the drug-resistant TB programme he helped establish in Khayelitsha remains close to his heart.
As with the ART programme, he has experienced tremendous success with this project.
“MSF enjoys the support of some six million private donors around the world, but it is because we are private that we are are able to tell the world of the atrocities we’ve seen.
“South Africa has a huge capacity to contribute to MSF, given the capabilities of its doctors and volunteers. We now send 140 volunteers to international projects each year, which is a significant portion. We are doing well,” said Dr Goemaere.