Statistics show that more and more people with HIV and AIDS in the rural areas of South Africa are suffering from depression. One organization, the Johannesburg-based South African Depression and Anxiety Group, is trying to turn this trend around by helping people in small communities, where the word for depression does not even exist in many local dialects.
On August 8, 1999, a very distraught woman in Johannesburg named Conny Setjeo, 23, decided to end her life. She had just learned she was HIV-positive. She climbed a tall building, and was going to jump off.
"I had tried to commit suicide after I just discovered my status," said Conny Setjeo. "I went on top of a building, and the brilliant idea that I had was that I was going to throw myself down and kill myself. I wanted to kill myself because I did not want to die. Brilliant, heh? Extremely, extremely brilliant."
What prevented her from jumping was a vision of her mother's face. She said the thought of her mother getting a call that her only daughter had committed suicide stopped her. She decided to go home and tell her mother the truth - she was HIV-positive, and likely contracted the disease from her husband, who had had an extramarital affair with someone who had HIV.
Ms. Setjeo found her mother to be understanding. "You know what she did?" she recalled. "She opened up her arms and said, 'Come here, baby. I love you even more.'"
Conny Setjo turned her life around. She is now a motivational speaker and an actress on a popular African TV show called, Soul City, which deals with the issue of HIV and AIDS.
What made the difference for her, experts say, is that she got the emotional support she needed to help deal with the disease.
According to Zane Wilson, who founded SADAG, the South Africa Depression and Anxiety Group, 10 years ago, if those suffering from the crippling combination of depression and HIV/AIDS do not get support, they are far more likely to commit suicide. One of the main reasons for the increase in suicide, she says, is the stigma attached to the disease.
"The stigma has always been huge, and one of the saddest examples I saw was when I was in a rural area in Siyabuswa, and I went past a graveyard," said Zane Wilson. "It was a Thursday, and they were digging quite a lot of graves. And, I went on another quarter [or] half a mile, and they were digging some more graves. And I actually asked the guy who was with me on the project, I said, 'why are they digging two graves?' 'One for the ordinary people, and one for the AIDS patients.' That was the first time I have ever heard that in some areas, AIDs was still discriminatory."
Ms. Wilson says people living in rural areas are particularly vulnerable, because there are no support groups like those in urban centers. To help change that, SADAG has reached out to rural areas to train caregivers and traditional healers in how to deal with depression.
This is a tough task, says Zane Wilson. "In the rural areas, they have a very different feel for it," she said. "There is no word in any of the black languages for the word, depression. And, when we first started talking, even to doctors in rural areas, they would say, 'no, black people do not get depressed.' but what they do say is that they have a 'heavy heart,' they have a 'black heart.' But, once you go into the communities and start talking to them about the symptoms, they will see it within their friends and families."
SADAG recently received funding from The World Bank to publish a talking book on HIV/AIDs and depression. The book is used to teach communities that have high levels of illiteracy about the disease.
"When you go to a clinic, hospital or doctor, they will ask you questions. Many people have depression. You do not need to feel ashamed. They will probably recommend talk therapy or counseling, which will help you cope with the feelings you are having."
Ms. Wilson said since the book was launched six weeks ago, communities have begun asking for more copies. "That one book is getting to so many people, and that helps to destigmatize [the disease] it," said Zane Wilson.
Conny Setjeo, who turns 30 years old in May, says while she has support from her family, she still has a difficult time with dating. Because she is on a popular television show and speaks openly about being HIV positive, she finds that, after one promising date, she often never hears from the man again.
But she still has hope, as is apparent in a poem she recently wrote about her life:
"I dont know how and when I am going to die.
"But I am wise. Wise enough to know how I am and why I am here.
"I dont know a lot of things. I dont know much about life either.
"But I am wise. Wise enough to know that I dont know."