South Africa Mandela: Down But Not Out

By Bruce W. Nelan/Johannesburg

When Nelson Mandela turned 70 last month, his visitors were surprised at how remarkably fit the black nationalist leader looked. Under the rigid discipline he has imposed on himself during the quarter-century he has been imprisoned on a life sentence for sabotage, he rose every morning before dawn for a two-hour workout. But four weeks ago, Mandela suddenly became short of breath. He had difficulty talking, then started coughing up blood. He was transferred from the medical wing of Pollsmoor Prison to Tygerberg Hospital, a major university teaching institution on the other side of Cape Town. Last week Mandela's lawyer announced the diagnosis: tuberculosis.

A highly contagious disease whose symptoms can frequently be ambiguous, tuberculosis is endemic in South Africa. Mandela might have inhaled the TB bacillus in prison and developed the disease immediately, though it is more likely to have lain quiescent in his body for years. Doctors drained three liters of fluid from around his left lung and prescribed antibiotics. Mandela, hospital officials say, is now "up and about and improving steadily," with the encouraging prognosis of full recovery.

No one is more determined that Mandela should get the finest medical care than South Africa's highest officials, who fear that he might die in jail and set off an explosion of violent protest in the country's black townships. Justice Minister Kobie Coetsee, who oversees the prison system, made a point of visiting Mandela at Tygerberg. Minister of Health Willem van Niekerk sent regular bulletins from the doctors to State President P.W. Botha. In reply to a worried letter from the Rev. Frank Chikane, general secretary of the South African Council of Churches, Botha assured him, "We are even more concerned and do wish Mr. Mandela a speedy recovery." Botha added that the patient had said he was satisfied with the treatment he was receiving and had not asked to be examined by outside doctors, as Chikane and Mandela's wife Winnie had requested.

Mandela's illness triggered fresh demands from around the world for his release. Botha knows if Mandela dies an imprisoned martyr, widespread violence is likely. On the other hand, his release might be greeted by an uncontrollable uprising of millions of black South Africans for whom he is the leading symbol of resistance to the apartheid system. Last week Botha renewed his long-standing offer to free Mandela if he would publicly renounce the use of violence for political ends -- a bargain Mandela has repeatedly refused on the grounds that prisoners cannot make deals.

Addressing a congress of the ruling National Party in Durban, Botha said he did not think Mandela should "choose to go back to prison" and that he hoped Mandela "will make it possible for me to act in a humane way." That meant, he said, that he was prepared to release Mandela if he would reject political violence and pledge not to support those who use it.

There is no indication that Mandela will agree this time, either. He remains loyal to the African National Congress, whose declared policy of "armed struggle" in South Africa he helped shape before he was imprisoned in 1962, and he would view such a renunciation as a betrayal. Thus an ironic catch keeps the ailing and aging Mandela behind bars. If his life is in danger or if he is badly weakened by his illness, he will almost certainly be released. But if Mandela continues to improve and regains his health, he could remain imprisoned for many more years to come.