Sunday Times, South Africa - May 28, 2000
Bobby Jordan

The city's official death rate has doubled over the past five years, according to the latest figures released by the Greater Johannesburg Metropolitan Council.

Johannesburg's director of cemeteries and crematoriums, Dr Alan Buff, said the mortality figures showed about 70 000 people in the city died last year out of a population of four million, of which 30 000 were buried or cremated by the council. Five years ago 15 000 were buried or cremated. These figures exclude burials in traditional areas or cremations at private facilities.

A large proportion of young adults make up the latest body count.

"There are many influencing factors . . . but what is most disturbing is the marked increase in the death rate of the younger generation of people between 20 and 50," Buff said.

Many of the city's 27 cemeteries were nearly full. Fourteen are already classified "passive" cemeteries, with bodies buried one on top of the other in "family" graves.

A move to promote cremation had yet to bear fruit, with communities still favouring traditional burials, Buff said.

The 100% increase in mortality recorded by the council over the past five years far outstrips the city's population growth for the same period. Health officials say it provides conclusive proof that AIDS has hit town with full force, and should finally put an end to the widespread public perception of an "invisible disease".

Another telling figure is the estimated 6 000 pauper burials each year in the city. Unclaimed bodies buried in nameless graves, many are believed to be AIDS victims abandoned by relatives.

There is also mounting concern about a rapid increase in AIDS orphans, many of whom move or are sent to Johannesburg from rural areas, and the debilitating effect the pandemic will have on the country's economy.

AIDS-related insurance claims rose 28% in the year ending June 1998, compared with the total number of insurance claims registered for the previous 10 years.

Concern over Johannesburg's mortality rate follows shocking evidence of AIDSrelated deaths in KwaZuluNatal - considered the AIDS epicentre in South Africa. The number of people dying in Durban has increased by 250% since 1994, according to a statement last week by Agriculture and Environmental Affairs MEC Narend Singh.

Singh said the number of burials and cremations had risen from 2 592 in 1993/94 to 8 983 in 1997/98.

"If moralities are going to continue increasing at that rate . . . disposal of the dead is going to become a critical problem," he said.

Dr Liz Floyd, director of Gauteng's AIDS programme, said Johannesburg's mortality figures might be inflated due to the influx of AIDS patients who seek treatment in the big city. AIDS was nevertheless painfully evident throughout Gauteng.

"AIDS deaths became noticeable in 1998. By 1999 we were able to see a different approach among communities, who up until then were in denial about the cause of the many deaths within their communities. Right now, only a few people are still in denial. For most people, there is an incredible seriousness about AIDS," she said.

She said the Gauteng Health Department was focusing on upgrading the province's 300 clinics to deal with the situation. "At the moment, about 50% to 60% of our clinics can cope with someone who is HIV-positive. This has to increase to 80% to 90%."

Dr Malcolm Steinberg of the research group ABT Associates South Africa, said projections suggested that more than 3.5-million South Africans are HIV-positive, and the figure was expected to more than double over the next decade. Average life expectancy could plummet from about 60 years to around 40 years by 2008.

By 2005 there are expected to be around 800 000 orphans under the age of 15. This figure will rise to more than 1.95 million in 2010.

"The impact of the pandemic is here. AIDS deaths are upon us," he said

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