Navigating Syndemic Suffering in Johannesburg’s inner city: Ada’s Story

For my master’s thesis, which explored the experiences of syndemic suffering among Nigerian-born women in inner city Joburg, I interviewed Ada, a vendor of Nigerian-made snacks (salted cashew nuts and peanuts) in the city. After moving from Nigeria to Joburg, Ada’s husband abandoned her and their children to be with another woman, leaving her to raise the children alone. However, in addition to the pain of betrayal and financial difficulties, and the precarity, she experiences, her mental and physical health has deteriorated since she arrived in Joburg. In our interview, I asked 36 years old Ada, about her experiences as a migrant in Johannesburg, to which she said,

Since the time I got here, I noticed that nobody even wants to see us here. For instance, one day I was going from my place to CBD. I was having a R50 note, and I didn’t have any other change with me. From the place where I entered the taxi to the place, I was going to is R5. So, I paid with the R50; I notice that the driver was busy speaking their language and giving every other person their change, but he didn’t give me. So, when I asked for my change, what he did is that they were talking in their language and then he brought the R50 and asked me, ‘this R50, whose head is here?’ The people in the taxi shouted ‘Mandela’. And he said, ‘you stupid Nigerian Ma Kwerekwere you come here to our country to take our money, it’s our money, not yours.’ That was how I thought it was a joke, but that was how this driver took my money. And all the passengers were clapping and laughing. And they said yes, this is how we will treat them until they leave our country. I was shocked to my bone. What I did was to come down from that taxi and I entered another one. And that was how I was crying like a baby. I felt like an outcast (Ada).

She describes how her physical and emotional health suffers because of the challenges she encounters,

I have hypertension. Before, I used to think that hypertension is for old people, but because of the experiences I have here, I have developed hypertension and I take my medication every day. With every little thing, I am stressed out and my BP will just go high.

The story of Ada is a prime example of syndemics, wherein multiple medical conditions interact and worsen each other, prompted by socioeconomic stressors. Her precarious work, being abandoned by her partner, and the othering she experiences as a Nigerian living in South Africa have led to her developing depression, anxiety, and hypertension.

Ada has, however, shown incredible resilience and agency in the face of challenges such as othering and financial difficulties. She has found ways to find joy and moments of respite, which is a testament to her strength and determination.

Ada is proactive about taking care of herself by engaging in self-care practices. She is taking positive steps to manage her physical and mental health by taking medication for her hypertension and actively seeking moments of rest and relaxation. She participates in fun events organized by the Nigerian Women’s Association in South Africa (NWASA), which provides her with a wonderful sense of connection and support from other Nigerian women in Johannesburg. These also events provide her with a much-needed respite from socioeconomic stressors and enable her to prioritize her personal health and happiness.

Ada has developed a great coping mechanism by focusing on things that make her happy. She is able to find joy in the little things, like making profits from the delicious snacks she sells or watching her children play. Ada’s ability to find joy in small moments and focus on the positive aspects of her life helps her maintain a sense of hope and optimism, even when faced with challenges. Also, Ada is determined to be an agent of change. She is aware of the systemic injustices that contribute to the challenges she and other migrants face and is determined to work towards an improved future. She is making a positive impact by sharing her experiences with researchers like me and advocating for herself and others through various migrant women platforms such as the ACTION support centre in Johannesburg.

Ada’s story highlights the complex and intersecting challenges that migrants face and the importance of addressing these challenges through a holistic and intersectional approach such as the syndemic lens. Ada’s story is a reminder of the strength and resilience of the human spirit and a call to action toward developing migrant-aware interventions to address the various risk factors that lead to syndemics.