THERE IS A single large tree on the wind-whipped salt-lake flats, the most marginal of marginal land. There are rivals – low scrub across the ground, bent by wind, introduced agave succulents with king-shard stems extending into the dust-filled sky, a few short and spiny trees – but only one tree. How do you create shelter against the stinging dust, the biting wind, the bulbous red-jelly sun that burns from near-dawn to dusk? You can build it out of scrounged wood, tin and plastic, but no one can stay indoors all day. The tree offers free shade beneath its spreading limbs, a patch of cool outdoors, a place to meet, mingle, talk.

This tree is the centrepiece of the founding story of Missionvale, an informal settlement of 120,000 people that has existed on unwanted land at the outskirts of Port Elizabeth, South Africa, for over a century. A new influx came during apartheid, when the coloured township near the wealthy white enclave of Walmer – a township of servants – was forcibly relocated in 1965. The land was too desirable; it could become suburbia. And so eight thousand people were uprooted and moved, their shacks bulldozed, and an entire new township deposited on the saltpans twenty kilometres away. After apartheid, new water pumps were installed and the population ballooned, as blacks and coloured began circulating, seeking a better life. Many found Missionvale and a Xhosa influx took the township to its present size.

No one has paid much attention to it; the middle class of Port Elizabeth drive past on the road to Uitenhage without noticing the timber-and-tin shacks thronging the salt lake. On the tourist map, a giant picture of an impala papers over the shadow city. But a diminutive white Irish nun wandered into this poorest of black settlements one day in 1988, in the last bitter years of apartheid, and knew this was where she wanted to be.

When Sister Ethel Normoyle first saw the city cobbled together from wooden slats and rusted tin she knew she would stay. ‘It was like the founder of my order, Mary Potter, said to me – you do not go any further. It was like a spiritual experience for me.’ Sister Ethel is tiny, a shock of grey hair fanning out above her like a nimbus, her Irish accent slightly tinted by thirty-eight African years, and surprising strength in her grip.

Sister Ethel found the single tree. Diane, its owner, offered it to her, and Sister Ethel accepted. Beneath its limbs, she began teaching curious children and befriended people from the settlement. ‘People knew I had nothing too, so it was a sharing of lives,’ she says. ‘I went house to house, and at first I did not want them to see that I was a nursing sister, because if I told them, they would think I was just a nurse. But then I saw a woman with her legs swollen and the skin all shiny, covered in dead layers. I peeled back the layers and her legs were crawling with maggots. For six months I collected spoonfuls of maggots from her wounds and put antiseptic on, and finally she said that she had been able to sleep a night for the first time in years.’ Word got around and soon there was a long line of people clutching sore bellies, legs and heads.

The Afrikaner authorities didn’t take kindly to a white nun looking after blacks, and threatened and harassed her most days. The harassment intensified when she moved to a black area close to Missionvale. She was once picked up for breaching the morality laws: hugging a black woman. The police dumped her in a remote, dangerous settlement, hoping the worst would happen to her.

Linda van Oudheusden, Missionvale’s office organiser, says that Sister Ethel hoped and longed for the end of apartheid. ‘She really believed in South Africa, in Nelson Mandela,’ she says. ‘She used to write to him when he was locked up at Robben Island, telling him to keep waiting, that he would be out soon.’

Apartheid collapsed in 1994 as the triumphant African National Congress (ANC) took power with Nelson Mandela at the helm. Over the next fifteen years, Missionvale grew as the ANC ended the hated laws restricting non-white movement.

By the late 1980s Sister Ethel had persuaded business donors to build three small rooms for a school and a clinic. ‘I was fortunate,’ she says. ‘A company came round one day. They really put me on the map. They said it was disgraceful that someone had to come from Ireland to do the work they should be addressing. So, they built the clinic we have.’

In 1988 Mother Teresa visited the small centre. Sister Ethel asked her if she could spare any nuns, but as she tells it, Mother Teresa paused for a long time before finally saying, ‘No. The people of Missionvale have Sister Ethel.’ And so Sister Ethel persevered, creating a microstate in the dust. By 1992 the care centre and clinic had grown. In 1995, Sister Ethel’s centre had two new pre-primary classrooms and a visit from the Queen, who mentioned Missionvale in her Christmas message. The instant media attention and comparisons to Mother Teresa made Sister Ethel squirm. She begs that the comparisons to Mother Teresa be stopped, but to no avail. ‘You have met Sister Ethel’, exclaim South Africans, white and black. ‘That woman – she is the Mother Teresa of Africa!’

MISSIONVALE IS ANOTHER world, parallel to the one the middle class inhabit. It’s five minutes drive from Port Elizabeth’s industry, docks, malls, freeways and beaches. Off the main road, the housing becomes less solid, fragmentary. Colours intensify, leaving behind the modern greys – here there are shacks of cement or tin, painted in lurid blues and yellows. Children are everywhere, extracting fun from nothing. They play cricket on rubbish-strewn ground, screeching at every hit. A snotty-nosed kid holds a kite made from plastic food wrappers and twigs. Many of the shacks are informal shops: hairdressers, shebeen bars and traditional restaurants serving ‘walkie talkies’ – chicken heads, beaks and feet.

MY GUIDE IS Sister Muriel, Ethel’s young offsider. She tells me that the soft-spoken Irish nun is creating something from nothing. ‘Sister Ethel is raising a village. That’s how I see it,’ she says. ‘If your skin wasn’t white enough during apartheid, if you were coloured, you had to be here. But it’s the same these days – people are still here and it’s growing.’

A nurse by training and coloured by skin tone, Sister Muriel has a permanent bedside manner. She moves adroitly through groups of people, distributing tut-tuts, advice and sympathy in small doses, pausing to speak quietly to a very thin young girl robbed of flesh by AIDS. Muriel tells me she’s in the late stages. The virus has become embedded in the membranes around her brain, making her confused. There is not long to go.

I help with food distribution. Women in colourful cloth stand gossiping and for a while I wonder where the need is. Then I spot the sick: gaunt, waiting uncomfortably, eyes on the food. Babies slumber, expertly tied onto mothers’ backs, woven into their fabric. Purple dresses, yellow, red. Afrikaans, so hated during the apartheid years, is still the lingua franca here, though these are Xhosa. The women stand out – laughter, chatting, teenage mothers sourcing tips from older mothers. The men are sterner, seemingly resentful. They do not laugh. No one looks thin from hunger – it’s the hollowness of HIV. The food we dish out is a mishmash of supermarket leftovers. The statements on the packets are cruelly ironic. ‘Great with your steaks,’ proclaim gravy sachets. ‘Here’s probiotic yoghurt to boost your immune system. Add two hundred grams of mince and stir.’

Another day, Muriel takes my parents and I out into the great expanse of the township proper. We are flanked by six laughing caregivers, local women who know this place intimately. They know who is sick, who has just died, who has just become an orphan.

Missionvale is a bleak salt flat, set against a backdrop of powerlines, metal monoliths and plastic bags flapping on thorn bushes in the ever present wind, living up to Port Elizabeth’s nickname – the Windy City. Township residents sit and watch us.

An Irish volunteer, Rose, has come along. She’s recently lost her husband to cancer – fresh from grief, rebounding from her role as carer, she’s here, throwing herself into life anew. She hovers over each scrawny child she finds, pressing marshmallows on them. Tin shacks, holes papered up with yellowed newspapers. We enter one. A woman, Olga, lies on a bed, dank sheets over her, her face sagging. A stroke? Or one of the minor ailments that grow, disfigure and disable? Her eleven-year-old grandson sits in a once-plush armchair and preens a little under our praise – ‘what a wonderful grandson, to look after your grandmother as well as you do’. But it is awkward: poverty tourism. Rose utters a faint ‘Jaysus’ and dishes out vast quantities of marshmallows, as if this ritual will stave off horror, survivor’s guilt. Mum asks Olga if she’s okay. ‘Yes,’ she says. ‘I’m just shocked at all these people.’ My mother begins making plans for rehab; Dad assesses her for sciatica. I’m proud of them, though our intrusion makes me uncomfortable.

THE VAST SALT flats are dotted by shacks and rough roads, but everything is obscured by clouds of topsoil. How do people find their way? Are there maps? The caregivers laugh. One taps her head; they’re up here. She points our way to the next place, where the rough-voiced Jackie lives in a sprawling tin-and-fibro house. The roof sags and aged lino sits on bare earth. Near her, a baby boy swaddled in a dress sleeps on a couch. ‘He was left at our house’, says Jackie. ‘The parents left him here, and one of the other women who lives here took him in.’ Her asthmatic voice sounds like it’s constantly catching on something. I ask how long she’s lived here. This shack looks timeless, unable to decay further, unable to improve, a liveable place. She mishears me, thinks I’ve asked her what I like about it. ‘It’s got a good view,’ she says, gesturing with a reed-thin arm to the salt lake twenty metres away. ‘There’s no industry, so there are no fumes. It’s good for my chest.’

We all take photos: huts, people, dogs. It’s demeaning, but I do it too, trying to hide the camera in my hand. A tiny girl sings to herself as she half-skips past. One shack has a TV blaring out state programming, drawing power from a car battery. Two men sit watching it. One stares impassively at me. His gaze is without anger, but it’s clear he does not want us there. ‘Can I take a picture of your house,’ my mother asks. He fixes her with the same gaze. ‘No,’ he says in a treacle-warm accent. ‘I would feel ashamed of who I am.’

A kid feeds two puppies from his bowl outside a nearby hut. Our procession moves past a young mother with two babies. There is weariness in her, despondency at odds with her sportswear and gold shoes. As we pass her, Muriel tells us her husband recently committed suicide. She has the bleak look of a survivor who must go on only for others.

I ask Nadia, the caregiver, ‘What is this place like to live in?’ ‘You are visiting, so you like it here. It’s different,’ she says. ‘But we grew up here. We are sick of it and we want to leave.’ That’s a universal hope, but escape is near impossible. Vista University, a squat wooden structure, sits on the hill above Missionvale. Nothing advertises its purpose and perhaps that is a kindness. Sister Ethel sees the university as a promise, a possibility, but then she is filled with hope. Linda tells me later that early excursions taking teenagers six kilometres to the Indian Ocean had to be abandoned. ‘Outside Missionvale is outside their world. Most had never seen the sea, and Port Elizabeth is a seaside city. Some became ecstatic when they saw it, but others were teary and distraught.’

SISTER ETHEL IS an outsider. She is Irish. She is also white – so how has she become accepted? ‘When I started out I did not have anything. I do not know if you were shown where I began? It is important for you to see the tree,’ she says, holding my gaze. For Sister Ethel, the tree is an essential component of her story. She was given something – the shade of a tree – so that she might begin giving herself. The tree is consent. To accept help is difficult and even more so from a stranger. Imagine then a white foreigner, under apartheid. So the tree is what enabled a quarter of a century of work spent building, building, building, in a place where no one builds things which last.

But: to take without giving yourself leads to dependency, complaints and demands. To ensure she has consent, Sister Ethel asks something of people. If you are one of the hundreds of people who depend on the care centre for food you must bring a bag of rubbish as payment, every day. And before she set about gathering funds and labour and material for the church, Sister Ethel asked for contributions from a small group. As the hat passed by, each person dipped into their small stores of coins, pooling 13 rand (about $2). People brought in pieces of broken glass to be melted down and reformed into the cross atop the church. South Africa was not part of the early life plan for a young Tipperary woman. ‘When I was growing up, I was very focused on getting married and having children,’ she says in her soft brogue. But she felt a certain calling and decided to enter the convent for a six week trial run. Six years later, she was still there and about to be sent to South Africa. ‘I would say it is God’s grace – something I cannot put into words – that led me and kept me where I am,’ she says. ‘If I had my life all over again, I would not have chosen anything else. I find I have a tremendous amount of joy. The joy gives me happiness and the happiness gives me joy.’

Sister Ethel was the last of her order – the Little Company of Mary – to be sent overseas without a choice. Later nuns could say no.

‘I am very much a home person, and my family are very important to me,’ she says. ‘Twelve young girls entered with me and they all said they wouldn’t mind going to Africa, but I was the one who said, Oh, I will do anything in Ireland,’ she says, stressing anything. ‘I didn’t want to be away from my family. But I was the one who was sent.’ In 1972, she felt the weight of the African sun for the first time. ‘It just broke my heart to leave home. But at that time, you were told to go,’ she says. Acutely homesick, Sister Ethel threw herself into her work. The plight of the black poor was obvious immediately, and for the next fifteen years, she used her training as a nurse to tend to the poor in two outstations. There was poverty there, but nothing like Missionvale.

‘In 1985, a time came in my life where I could say to myself, If I don’t go, they will never own the project and what we built up. As I explained it to them, you walk at my pace now, but you have the ability to fly.’ Sister Ethel felt the pull of Ireland as well, and she returned home, but it wasn’t long before her superior asked her to return to Port Elizabeth, where the need had not diminished In 1988, she ventured into Missionvale and found a tree to tether herself to. ‘When people found me down by the tree, I was a nurse who came to visit,’ she says ‘But I was also into education, and I feel it is only education that will change this whole scenario around. So I taught kids in the morning, and nursed people in the afternoon. I remember one girl – she was beautiful. I will always remember her eyes. The first day, she literally slipped her hand into mine. I taught her to write her name, and then I wrote under it, I am beautiful. That was a wonderful day. Anyway, she later gave birth to three children, and she has died, you know, of AIDS, and two of the children have too. But still, she is a very special person in my life.’ A sadness plays around her eyes, and for the first time I see the bone weariness that has come of so many years here, in this dusty spot with forgotten people.

THIS IS A story of how a young Irish woman found herself tending to South Africa’s poor. But that makes it sound too simple. Look at the complications. Near the tree is a wide stretch of open grassed land – rare, for this densely populated shack-land. It exists because soon after Sister Ethel arrived, so did HIV. By the early 1990s people were dying near where she first began teaching and nursing. It is cursed land, afflicted by the then-unknown wasting disease.

Even now the land is untouched. When the Missionvale Care Centre was built, it had to be a kilometre from its founding place of myth, to avoid the stigma of the land. For this is what must be done – adaptation. You cannot simply tell someone that there is no connection between the work of Sister Ethel and AIDS. You must slow yourself, ready yourself for a different mental architecture. How could it be coincidence that a white stranger arrives and then this virus, so close together? As the years went by and AIDS spread from the first few infected near the tree across the whole settlement, suspicion of Sister Ethel eased. But the land is still bare.

I HAVE COME late to this place. The graveyards are full, and new splinter graveyards are emerging. Three years ago the hill behind Missionvale was bare, rocky and arid, but now, with the settlement in the grip of this stealth virus, the hill has been planted with bodies – dozens each weekend. Hundreds upon hundreds of graves dot the hill, wind-blown plastic bags tugging on wooden slat crosses. Who survives this pandemic? Half of all pregnant women have HIV, and so children are born already half-dead. Tuberculosis is widespread, too – carrying off those weakened by HIV. It is those too young or old for sex who survive. A family in the age of AIDS is grandparents looking after their children’s children. When the grandparent dies the oldest child steps up, cradling siblings, eking out a living. What can be done? The Vatican still holds out on condom use, but the Vatican is a long way away. ‘We preach abstinence, but you have to be practical as well,’ says Sister Ethel, quietly. ‘I am very direct and I ask very personal questions,’ she says, fixing me with bright eyes. ‘With every man that comes to me, I would ask them, Are you living with somebody? Is that the only person in your life? Or do you have multiple partners? They have great trust in me and that is wonderful.I do not take that for granted. Then, I would say, Okay, you know what AIDS is?‘ She pauses, remembering countless stories. ‘They would say, Sister, how could you think I have AIDS? I would say, Well, maybe you have or maybe not. What about having a test? I know they resent this and I say, If you resent it, you commit to me to come again. I would ask for a commitment between them so that they would have sex only with their partner and with the commitment of a condom, you know. They say Yes to me and I have to believe that they do. I have not yet found that any man that have said he will come back have not come back.’

With the women, Sister Ethel asks, is your man faithful to you? If not, she delivers a firm warning: ‘If he demands sex when he comes back, you make sure he wears a condom. This is a life and death situation.’ Often, it is too late and the woman already has the virus. ‘I must provide for them and take care of the illnesses they have. That could be pneumonia, TB, skin diseases. But I say to them that they must have time for themselves. In their home, there is no way to have privacy. But at church – they can have that time with God, to keep the spirit going.’

After years of witnessing domestic violence, abuse and a culture of male domination, Sister Ethel is tired of dancing around words. ‘It is very much the culture of men – the more children I father, the more of a man I am. What really upsets me is when the man does nothing to bring food in, yet he is the first person to be fed.’ Her voice tightens. ‘I must say, I love men and I can’t do without them and a lot of men have helped me, but there are sometimes I just do not want to see another man because what they have done to the women. I see those hungry children and those hungry women and I see how hard that woman has struggled to provide and the man demanding the food. Many women are beaten because they cannot provide what he wants. Women are blamed for giving their husband AIDS, when he has been the culprit 99 per cent of the time,’ she says bluntly.

What this means is that efforts to change sexual behaviour face a near-impermeable cultural wall. HIV is now a permanent epidemic in Missionvale, as in most of South Africa. But here, as in many countries, anti-retroviral (ARV) drugs have been rolled out. The drug cocktail takes a toll on the body, like chemotherapy. But they can contain HIV, prevent it from utterly destroying the immune system, and indefinitely stave off the AIDS death from small infections. The new tragedy of Missionvale is that you can only qualify for ARV drugs when you are nearly dead. So you flirt with death to earn money from the state, and to get your life-prolonging drugs. And so people play the game, wait until they sicken, waste towards death and then, they hope, the money comes, the drugs come, life comes surging back. But often, very often, death comes instead.

I ask how she can stay optimistic in such a place. Sister Ethel’s method is to mix pragmatism with spiritual idealism, nurse with believer. ‘While people are alive, I try to give them a life so that they can die well. If they do not experience love and care when they are nursed, it is very hard for them to believe there is a better place for them when they die,’ she says. ‘But what I see as the bottom line is dignity and respect for the people and making people aware that all of us have dignity, and poverty does not diminish that.’

At the church service on a Sunday in January, Missionvale’s Xhosa and coloured burst into song. Sister Ethel sways to the African songs but doesn’t sing. She grins and watches her flock. As the mass reaches its climax, a mammoth black woman stands, brushing off her belly. She strides into the aisle and sets herself shaking, her entire body wriggling, pulsing, convulsing. The crowd pours into the aisles. They cascade to the front of the church, surrounding the baffled Irish volunteers, who whip out cameras, the modern coping mechanism. The women lead the way, the strong ones. A two-year-old dances with her mother, taking her first rhythmic steps. After the final shake and chorus, the visiting Irish priest goes outside, clearly wondering what happened to him. ‘That was great,’ he says, half-dazed. ‘We have to have another one like that.’

Afterwards, in her office, Sister Ethel says it plainly: ‘You have to adapt.’ Bending and accommodating makes dignity possible. Sister Muriel pokes her head around the corner, and Sister Ethel perks up. Making her farewell, she returns to her people. Muriel watches her fondly. ‘She never stops looking after us all. You can tell she cares a lot for others because she doesn’t take care of herself. She values us more and more. If she goes home in the evening, she doesn’t sit down. She prays for those who have lost loved ones. She writes thank you letters. She phones parents. She makes Christmas gifts. That’s what she does. All the time.’