Mon séjour en Afrique du Sud (Cape Town)

South Africa's National Defence Force has a daunting list of deployments at the moment: ceasefire observers in Darfur; peacekeepers facing down a whole collection of vicious rebels in the Democratic Republic of Congo, keeping a fragile peace in Burundi, trying to restore it in civil-war-torn Ivory Coast.

But the SANDF also has a huge problem at home: A quarter of its uniformed soldiers are infected with HIV-AIDS, and the disease is taking its toll. “We've come to a point in our combat readiness where if we have to get involved in many more new missions, we will have trouble to fill the gaps,” Brigadier-General Pieter Oelofse, the director of medicine, said bluntly.

This has huge implications for this country's security, obviously, but also well beyond South Africa's borders. As the best-equipped and best-trained military force on the continent, South Africa is doing much of the region's policing these days. In conflicts such as Darfur, South Africa has stepped in as a proxy where countries such as the United States and Canada — whose governments still remember the Somalia debacles more than a decade ago — won't send their own troops, but want an international presence.

Military infection rates are estimated to be up to twice those in the wider population, according to the Pretoria-based Institute for Security Studies. Seven out of 10 military deaths in South Africa are AIDS-related. AIDS is also the biggest killer in the Ugandan armed forces, and Zambia is pushing to get treatment for soldiers. Eritrea has made a “condom pouch” part of its standard-issue military kit. Ethiopia and Nigeria, two of the continental heavyweights, have raging epidemics within their armed forces.

There is a simple set of reasons why soldiers are particularly at risk. “They deploy at 19 or 20, they are young, healthy people with all the normal levels of hormones a person should have and the effect of those hormones is not shied away from, if I can put it like that,” Gen. Oelofse said. Then, he added, they get training that is predicated on their courage. “They are young and healthy and fit and they think that it's not going to happen to me — whether it's getting shot or snakebite or HIV-AIDS.”

Deployed abroad, the soldiers are away from their families or regular sexual partners. “Those desires don't suddenly go away because you're not at home. You put all these things in a pot: ‘I'm young, healthy, invulnerable, I've trained to kill the enemy and the longer I am away from home the more difficult it is for me to stay in my room,' ” he said. “What comes out of that pot is high-risk behaviour. Add a few drops of alcohol to high risk and it doubles.”

The military here, like many other countries, has tried to counter these factors with aggressive HIV prevention campaigns, but the successes are limited. The SANDF has an annual incidence rate, or new infections, of 1.2 per cent of its 65,000 troops.

The United Nations currently bars countries from sending HIV-positive soldiers on international missions (although it is reviewing this policy), which effectively eliminates a quarter of South African troops from those duties. While no other country in the region has been willing to release the infection rates for their military forces, a senior military figure here said that the topic dominates many multilateral meetings, with grim discussion about the possibility that some forces could imminently be seriously disabled.

At the same time, research under way here may lead to a reconsidering of the HIV-positive army. Partnering with the U.S. National Institutes of Health, the military is two years into an ambitious research project on AIDS treatment. Almost 1,000 soldiers and their families are now on antiretroviral drugs, through Project Phidisa (extend life), a $50-million (U.S.), five-year project that is not only hunting for the optimal combination of the drugs, but is looking specifically at how a soldier deployed in a conflict zone could manage. (The drugs must be taken at the same time every single day for life, and may cause side effects that require medical management.) Given the reality of HIV infection rates in southern Africa, most countries will imminently be obliged to seriously consider deploying patients who are healthy but on AIDS treatment.

Sergeant Philisiwe Ntshangase, who is the project's patient advocate and runs support groups for HIV-positive soldiers, is a plump and cheerful testament. A former fighter in the anti-apartheid movement, she was part of the integration of guerrillas and soldiers in the new armed forces here after the first democratic elections in 1994. A year later, she tested positive.

“I thought it was the end of my career,” she recalled. “I started behaving not normal . . . I was angry. When you're a soldier you must be able to care for your fellow soldiers or your country. I wasn't fit — not mentally — to carry a weapon.”

She battled depression over the next few years, until she managed to stabilize her health on antiretrovirals in 2002. Now she confides with a laugh that she has to worry about counting calories.

Her message to her fellow soldiers these days is that with ARV treatment, they will be able to work just fine. “You can be promoted; your career doesn't stop.”

There have been snide suggestions in the media here that the U.S. government is pouring so much money into Project Phidisa because it has a vested interest in keeping South Africa's forces fit, and able to stabilize Darfur or Congo. But Gen. Oelofse said that misses the point. “From the negative point of view, you can say we are being abused, or I can be proud that we are doing something to benefit humankind and would not be done otherwise.”