Keiskamma Altarpiece

The first layer of the Keiskamma Altarpiece shows the crucifixion reworked through the experience of the Hamburg, South Africa, community. According to Dr. Carol Hofmeyr, this structure was inspired by the Isenheim Altarpiece (Colmar, France), which presents a crucifixion flanked by saints associated with disease. In the Keiskamma Altarpiece, these saints are replaced by women from the community whose lives were shaped by the beginning of the HIV/AIDS crisis.

At the center is a young widow standing in front of the cross, dressed in mourning clothes. Hofmeyr notes that widows were common at the time, as men who had worked in cities returned home ill and died, followed by others in the village. Groups of children appear nearby, representing families left behind. On one side sits a grandmother inside a house, based on a photograph, representing women who assumed responsibility for raising their children’s children.

On either side of the cross are two women shown as saints: Susan Poliso and Lagina Mapuma. Both were respected figures in the community, known for their strength. The lower section tells the story of Susan’s youngest son, who returned home ill after working on fishing boats. He was treated for tuberculosis, improved briefly, and later died in Susan’s home in Hamburg. Coffins and a graveyard appear nearby.

Between the scenes are embroidered names commemorating community members who had already died, along with the names of some of the embroiderers.

The second layer of the Keiskamma Altarpiece presents an imagined vision of Hamburg, South Africa, shaped by broad community involvement. This panel was created with a more informal visual style and reflects an effort to imagine the village without disease during the HIV/AIDS crisis. It corresponds to the Annunciation and Nativity panels of the Isenheim Altarpiece, which convey hope through religious narrative. Here, hope is expressed through scenes grounded in local life.

On the left stands a large coastal fig tree, a common feature in Hamburg that is associated with growth. At the center are representations of the religious groups present in the community, including traditional belief systems as well as Methodist, Anglican, and other Christian groups, shown through clothing and symbols.

One section features a local man known as Prophet Gaber, who created patterned designs in the sand after rain. His inclusion refers to creative activity within everyday life.

The final section presents Hamburg surrounded by water, including the river, lagoon, and sea, with a map of the village at the center. This scene presents an imagined version of Hamburg as a flourishing place, while acknowledging the contrast between its natural beauty and extreme poverty.

The third layer of the Keiskamma Altarpiece departs from stitched panels and introduces photographs, marking a deliberate change in technique inspired by the sculptural final stage of the Isenheim Altarpiece. The photographs were taken by Tanya Jordan, a woman living in Hamburg, South Africa, who was involved in the project at the time. This layer centers on grandmothers, whose caregiving roles expanded during the HIV/AIDS crisis.

One photograph shows Susan Poliso with her grandson, Lichile, the child of her son Dumile, whose burial appears in the lower section of the first layer. Susan learned of the child’s existence after Dumile’s death and raised him in her home. Another photograph presents Eunice Mangwani, a community health worker and the first HIV educator in Hamburg. After returning from Cape Town in the early 2000s, Eunice led HIV education efforts in a community where little information had previously been available. She later traveled internationally with the altarpiece, speaking about the work and the lives it represents, and became a key spokesperson during its early exhibitions. She is shown with her three grandchildren, including one child who is HIV-positive and received treatment.

A third photograph features Caroline, a grandmother whose daughters returned to her household with their children. She is included in part for her contribution to the wire and beadwork above the photographs, which forms local trees, including erythrina and thorn acacia. The outer panels return to the Keiskamma River, fish, and surrounding water, situating care, survival, and advocacy within the local environment.

This monumental work, measuring 13 feet tall and 22 feet wide, was collaboratively created in the village of Hamburg, South Africa, by over 130 community members, mostly women.

Due to its massive scale, the artists often had to lay the pieces out on the grass outside the studio and use ladders to view the developing composition.

The artists assemble the sections of the altarpiece in the open landscape of Hamburg, framed by the Keiskamma River, a central symbol of the community’s identity and ancestral fishing heritage.

This image reveals the initial stage of the intricate structural frame and specialized three-way hinge system designed and built by Dr. Justus Hofmeyr, the husband of project founder Carol Hofmeyr. Beyond his technical role in stretching and securing the panels alongside handyman Jonathan Bertani, Justus served as a prominent medical doctor who actively fought against the South African government’s era of HIV denialism.

During a period when the state refused to acknowledge the virus or provide life-saving antiretrovirals, Dr. Hofmeyr risked his professional standing to administer nevirapine—a drug essential for preventing mother-to-child transmission. He was one of the first to use the medication in Hamburg, South Africa, by informing the Minister of Health he was conducting a "clinical trial," a strategy that allowed him to continue providing treatment without facing termination.

Providing critical care when HIV was otherwise treated as a state-sanctioned "death sentence," his courageous actions helped preserve the lives and dignity of the community members whose stories are told through the embroidery supported by this hand-built frame.

"By the time we made it, which was very early on in Keiskamma, certain people had emerged as better at drawing. I had never wanted there to be artists and not artists, because I said everyone’s an artist." – Carol Hofmeyr

This detail portrays a widow, a central figure born from Dr. Carol Hofmeyr’s conceptual reckoning as she sought to translate the traditional crucifixion of the Isenheim Altarpiece (Colmar, France) into a contemporary Hamburg, South Africa context.

While Matthias Grünewald’s 16th-century painted original flanked the cross with saints relevant to the plague, Hofmeyr found her inspiration in the everyday sight of mourning clothes on a rural road.

By placing this young mother in front of the cross rather than upon it, the work reimagines the divine sacrifice through the domestic reality of women left behind by the epidemic. Her husband, like many in the community, returned from the cities only to succumb to illness, leaving a legacy of grief that the artists have stitched into a new form of sacred iconography.

The imagery of colorful fish and water represents the Keiskamma River in the second layer, a central geographical feature of Hamburg whose name likely originates from the Xhosa people, the original inhabitants of the region. In this layer, the river and its resources symbolize the community's connection to their environment and the reimagined flourishing of a village.

These details depict the diverse wildlife and natural environment of the Hamburg region in South Africa.

These details depict the diverse wildlife and natural environment of the Hamburg region in South Africa.

This detail in the second layer depicts birdlife among the branches of a coastal fig tree, representing the flourishing environment of Hamburg.
According to Dr. Hofmeyr, the inclusion of birds and local flora in this layer signifies a reimagining of the village as a space of health and prosperity, contrasting with the themes of illness in the previous layer.

This detail depicts the physiological impact of the epidemic through an emaciated body in the first layer. Dr. Hofmeyr noted that this layer was intended to be "full of death," documenting the physical decline witnessed in the Hamburg community during a period of medical scarcity.

This central panel of the second layer documents the various religious groups active within the village of Hamburg, South Africa.

The composition, designed by the local Xhosa women, depicts traditional religion at the base, followed by the specific uniforms of Methodist and Anglican church members, and other non-aligned Christian groups.

These scenes serve as a collective reimagining of Hamburg without disease, where the presence of these diverse belief systems offered a sense of hope during the height of the HIV crisis.

This close-up reveals the intricate embroidery used to depict the church uniforms that signify various religious groups within Hamburg, South Africa.

The artists utilized these distinct garments as a visual narrative of the village’s faith structures, which served as central elements in their collective effort to reimagine a community defined by hope rather than disease

This detail in the second layer depicts cattle grazing within the coastal landscape of Hamburg. In the context of the village, these animals represent a central element of the community's traditional rural economy.

These details feature sculptural elements crafted from wire and beads, depicting local animals and a flower. Dr. Hofmeyr noted that this technique was utilized for the upper section of the third layer to represent the natural environment and prosperity of the village.

These details feature sculptural elements crafted from wire and beads, depicting local animals and a flower. Dr. Hofmeyr noted that this technique was utilized for the upper section of the third layer to represent the natural environment and prosperity of the village.

These details feature sculptural elements crafted from wire and beads, depicting local animals and a flower. Dr. Hofmeyr noted that this technique was utilized for the upper section of the third layer to represent the natural environment and prosperity of the village.

These details feature sculptural elements crafted from wire and beads, depicting local animals and a flower. Dr. Hofmeyr noted that this technique was utilized for the upper section of the third layer to represent the natural environment and prosperity of the village.

This section at the base of the altarpiece, called the predella, depicts a domestic scene in which multiple family members are confined to bed. The inclusion of an older individual alongside a younger couple, all showing signs of extreme physical decline, records the multi-generational impact of HIV on individual households within Hamburg, South Africa.

Documentary Narrative of the HIV Epidemic:
This section at the base of the altarpiece, called the predella, details a person in a state of advanced illness, with red spots across the body representing the symptomatic reality of the HIV epidemic. Dr. Hofmeyr noted that these depictions were intended to document the biological truth of the period when medical treatment was not yet widely accessible.

The Village Funeral:
The final scene at the base of the altarpiece shows a group of community members carrying a large coffin, representing the frequency of local funerals during the height of the crisis. This imagery grounds the monumental scale of the altarpiece in the specific, lived experience of loss and the collective responsibility of mourning within the village.

This detail depicts fish within the side panels of the third layer, representing what Dr. Hofmeyr describes as the "very, very beautiful environment" of the Keiskamma River. Hamburg, a coastal town in the Eastern Cape, relies on small-scale and subsistence fishing to support its local economy and community.

This detail depicts fish within the side panels of the third layer, representing what Dr. Hofmeyr describes as the very beautiful environment of the Keiskamma River. While the central portion of this layer utilizes photographs and beadwork to honor community grandmothers, these embroidered side panels focus on the natural surroundings of the village.

The side panels of the third layer feature the Keiskamma River alongside the names of the Xhosa community members and the artists involved in the project. Dr. Hofmeyr noted that these embroidered names serve as a remembrance for those in the village who had died, while also acknowledging the individuals who contributed to the creation of the work.

This detail depicts fish within the side panels of the third layer.

This detail depicts local fish within the side panels of the third layer.

The side panels of the third layer feature the Keiskamma River alongside the names of the Xhosa community members and the artists involved in the project. Dr. Hofmeyr noted that these embroidered names serve as a remembrance for those in the village who had died, while also acknowledging the individuals who contributed to the creation of the work.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

These details from the second layer depict the diverse wildlife and natural environment of the Hamburg region. Dr. Hofmeyr noted that this layer was designed to represent a flourishing version of the village, utilizing local imagery of the Keiskamma River and its surrounding ecosystem to illustrate a community reimagined without the presence of disease.

MAKE ART/STOP AIDS brought The Keiskamma Altarpiece to the Cathedral in Chicago as the first stop on its U.S. tour, showcasing stories of loss and resilience from the village of Hamburg, South Africa.

This photograph depicts Eunice Mangwane in her home village of Hamburg, South Africa, surrounded by members of the press and local residents. As the first HIV educator in the village and a central figure in the Keiskamma Art Project, Eunice is seen here occupying a role of advocate for the community, mediating between the lived realities of her community and the external gaze of the media.

This image records Dr. Carol Hofmeyr, physician and founder of the Keiskamma Art Project, delivering an address within the Cathedral Church of St. James.

Hofmeyr occupies a role that bridges clinical medicine and community-led creative practice. Her leadership emerged during a period of profound medical scarcity and political denialism in South Africa, where she posited that art could hold suffering and provide a sense of meaning when pharmaceutical answers were inaccessible.

This moment at the AIDS conference 2006 marks the realization of her effort to prove that visual storytelling functions as a bridge between the people of Hamburg and the world, anchoring the survival of a community within a global narrative of persistence.

This image depicts Eunice Mangwane in dialogue with actor and activist Richard Gere at the Cathedral Church of St. James, Toronto, a significant site for the cultural program of the 2006 International AIDS Conference. Gere played a role in publicizing the altarpiece's journey.

Eunice Mangwane is depicted presenting the work to the public within the Cathedral Church of St. James, positioned directly before her photographic likeness in the third layer of the altarpiece. Visitors to the installation were frequently captivated by her storytelling skills, which provided a personal, human resonance that matched the technical scale of the work. This layer centers on grandmothers and caregivers, whose labor expanded during the South African HIV crisis in the early 2000s.

This photograph captures Eunice Mangwanie singing within the sanctuary of the Cathedral Church of St. James, an act that provided a sonic dimension to the project’s storytelling. As a healthcare professional and artist, Eunice's vocal contribution functioned as an instrument of advocacy, drawing the public into the shared history of the Hamburg community.

Among the hymns performed by Eunice was “Shine in Your Corner,” a selection remembered by Dr. Carol Hofmeyr as a defining element of the project’s international tour. The presence of Eunice's voice within the cathedral sanctuary established a point of human connection between the people of Hamburg and the global audience, effectively addressing the silence imposed by the political and social denialism of the era.

The Cathedral Church of St. James (Anglican): Located at 106 King St E, this 1853 Gothic Revival cathedral is in the heart of downtown, Toronto.