What last week’s vandalising of our research clinic in Kliptown, Soweto, means to science

The consulting room doors were damaged and glass was broken to gain access to computers and medical equipment. (Photo: Anusha Nana)

By Glenda Gray, Anusha Nana, Erica Lazarus, Fatima Mayat and Ravindre Panchia

21 Jul 2021

Despite the critical role of the Perinatal HIV Research Unit as part of the national and international Covid-19 response team, it was not spared during the recent unrest. Loss of scientific equipment, research and infrastructure as well as threats to researchers’ safety compromises the ability to conduct the clinical research needed to address the pandemic and epidemics like HIV and TB.

Anusha Nana, Erica Lazarus, Fatima Mayat and Ravindre Panchia are with the Perinatal HIV Research Unit, Faculty of Health Sciences, University of the Witwatersrand. Glenda Gray is with the PHRU and the South African Medical Research Council.

More than 15 years ago, the Perinatal HIV Research Unit (PHRU) established its first adolescent and HIV research clinic in Kliptown, quite literally doing ground-breaking research on the ground. We chose Kliptown because of its historical significance as well as the desire to dignify this auspicious square with the clinical science that it deserved. Right across from our offices and clinic, 76 years ago, in this square now known as Walter Sisulu Square, the Freedom Charter was signed, setting out the aspirations of the opponents of apartheid.

The Freedom Charter emphasised a non-racial society, liberty and individual rights. This Charter is seen by many as the foundation of South Africa’s 1996 constitution. In the spirit of this legacy, we established the Kliptown Research Clinic employing almost 50 people with more than 80% of employees living in the surrounding areas. We never lost sight of the significance of having our research site on the square.

This is the Kliptown Research Center main clinic area with the reception, eight consulting rooms, four administration rooms and a patient waiting area. (Photo: Yolandie Fourie)

Significant too, is the research we have done here, that has had a global impact. Established in 2008 as the Kganya Motsha (translated as “shine young one” in Sesotho) this site was the first in Soweto to provide youth-friendly HIV prevention, outreach, HIV testing services and psychosocial support to adolescents and young people. We extended this to doing medical research and exploring whether a gel containing an antiretroviral agent, tenofovir, could be used as a vaginal microbicide to avert HIV in young women.

Kliptown Perinatal HIV Research Unit (PHRU). (Photo: Anusha Nana)

We too have enrolled in pivotal HIV vaccine efficacy trials that contribute at a global level to the scientific assessment of what it will take to mount an immune response adequate enough to prevent HIV acquisition. Soweto is an HIV transmission hotspot and the most densely populated geographic location in South Africa. Given the high HIV prevalence and incidence, and lack of acceptable prevention modalities, a moderately efficacious preventative HIV vaccine or long-acting pre-exposure prophylaxis (PrEP) would be a critical contributor to ending the HIV pandemic. We are proudly trying to find the HIV holy grails, and our site is critical to this endeavour.

Although we have been part of the two most important and largest HIV vaccine trials in Africa, more recently and maybe more importantly, when Covid-19 struck our country, we rapidly availed ourselves to conduct the first-ever Covid-19 vaccine trials in South Africa. We were involved in the Chadox/Astra-Zeneca study that showed significantly reduced efficacy against the so-called South African or Beta variant.

Professor Glenda Gray visits the Kliptown Perinatal HIV Research Unit (PHRU) Kliptown Research Centre. She is speaking to receptionist Nomathemba Madise about daily clinic visits. (Photo: Anusha Nana)

We contributed to the selection of Covid-19 vaccine candidates for the South African national vaccine roll-out by implementing the Ensemble trial of J&J’s single-dose Ad26 vaccine. This trial was the precursor to Sisonke, the study which made 500,000 Ad26 vaccines available to healthcare workers as an implementation study when the government’s roll-out faltered. The Kliptown staff supported the vaccination drives at Chris Hani Baragwanath Academic Hospital and a private facility in Lenasia.

Our site, headed and run by a predominantly female team, has forged relationships with the tenants on the square and supported local entrepreneurs to ensure we can all co-exist and thrive together in the Kliptown community.

The Perinatal HIV Research Unit (PHRU) Centre entrance wall that was vandalised to gain entry to the clinic. (Photo: Anusha Nana)

Tragically, Walter Sisulu Square and the surrounding businesses were some of the worst-hit places in Gauteng during the recent violent and destructive riots. Shops and medical practices were looted, some burnt to the ground, and owners and tenants left destitute. Barely any of the tenants of the Square’s office building were left unscathed. Many of these businesses provided much-needed services to the community, including our clinic and neighbouring establishments such as New Heights which provide entrepreneurial and life skills courses with a special focus on women, youth and the unemployed.

Despite the critical role that we play as part of the local and international Covid-19 response team, our site was not spared during the riots. Opportunists broke into our main facility and stole all electronic equipment, including desktop computers, laptops, printers, mobile phones, televisions for participant education and a washing machine used to ensure sanitised staff scrubs.

The reception area wall that was broken through allowed looters access to the clinic to steal computers, printers and medical equipment. (Photo: Anusha Nana)

They also took all our stethoscopes, blood pressure machines and space heaters. It will be difficult to restore the functioning of this once vibrant floor, as the taps stolen from the Square’s main restrooms and vandalised toilets have resulted in the water supply for the entire building having to be turned off.

With no water access and absolutely no ablution facilities in the entire building — a worrisome health hazard to the already traumatised tenants amid the third wave, this will impact on our ability to restore clinical research. Although we have suffered a chronic lack of access to adequate basic services to the building, we have always made a plan.

The consulting room doors were damaged and glass was broken to gain access to computers and medical equipment. (Photo: Anusha Nana)

For example, the facility has been without electricity since 15 December 2020. We installed generators to run the research freezers and fridges in which the vaccines are stored but this came at an estimated cost of R4,000 a day in diesel. When nothing was done to rectify the situation, we were forced to hire private contractors to connect the site to the main power supply. However, we had to dip into the minimal resources that we had to do this and now do not have sufficient funds to extend this to the other tenants who remain without power.

Clinical science does not operate in a vacuum and is part of the ecosystem of communities. Loss of infrastructure and equipment, threats to researchers’ safety, and an inability to keep research clinics open in the field compromise our ability to do the clinical research needed to address this current pandemic and other pandemics or epidemics like HIV or TB. Loss of this ability makes us all the poorer.

So, despite all our challenges: looting, poor infrastructure support, security concerns, we are resilient and resourceful. We remain committed to Kliptown, because of our passion, a sense of community and love for the research we do. We will rebuild our site. Science can have setbacks, Kliptown can have setbacks, but our phoenix will rise again. Much like the phoenix — the long-lived bird that cyclically regenerates or is otherwise born again — we will obtain new life and will continue to make a global impact. DM/MC

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