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Why are We Losing the Battle Against AIDS? Why are We Losing the Battle Against AIDS? unacceptable truth: an entire generation of young Swazis is dying. WHY ARE WE LOSING
Why, after having known about this problem for more than fifteen years, does it seem as if AIDS cannot be conquered in Africa? After having made a THE BATTLE AGAINST AIDS?
study of this topic, I consider the following as some of the main reasons whyit seems as if we are losing the battle against HIV/AIDS in Africa: In, what must have been one of the most distressing articles I ever read on 1. DENIAL
the topic of AIDS in Swaziland, someone wrote the following in a localSwaziland newspaper, under the heading THE PLAGUE ON AFRICA: Denial is often considered to be the number one enemy hindering progress in the battle against AIDS. Denial occurs on many levels: A lament rises every Sunday at dawn from the half-dark valleys of Swaziland, a lament so sweet, says local resident Jane Slabbert, that it Denial by those not affected by AIDS
seems to carry the souls of the dead up to heaven. It rises here, there,everywhere from the processions of mourners who make their way from It is well known that individuals experiencing a personal crisis such as cancer go through a long process consisting of different phases. They usually Saturday night has become the night of vigils, of traditional Swazi start by denying the problem (It can’t be; the doctor is wrong), then move to wakes, when friends and relatives gather to feast and to mourn the deaths anger (Why did this happen to me; I hate God), and after a number of other of young people, the cream of the nation. As the AIDS pandemic gathers steps eventually get to the point where the inevitable is accepted (I have cancer pace, Swaziland has entered an endless season of mourning. – I must start planning my life accordingly). In the case of a national disaster The vigils are announced publicly in death notices that fill a page, or such as AIDS, where not only an individual or a family, but entire communities often two pages, in the local newspapers every day. Many are accompanied and ultimately entire countries are affected, this same process seems to occur by photographs which show that almost all the victims are in their twenties within such communities. While some people have progressed to the anger or early thirties. The language of the announcements is both quaint and stage (AIDS is God’s solution for the over-population of Africa, or I have AIDS. evasive: George Shongwe is late; Zodwa Madolo, nee Diamini, died I’m not willing to die alone, therefore I will infect as many people as possible suddenly and is late, Cynthia Zwane is late. Friends and relatives are while I have the opportunity to do it), the majority still seem to be in the denial informed that the vigil will be on Saturday night, the funeral early the next phase of the process. When discussing this problem with Western people, I often find a total disbelief about the disastrous effects which AIDS has in There is no hint of the cause of these deaths, though everybody knows. Africa. The words of a white minister with whom I discussed this problem The universal human response to AIDS is denial. It is as though nobody can recently, sums it up very well, when he said to me: “The people telling us about face the awful reality of a calamity that rivals the great plagues of history. AIDS are exaggerating when they give us the statistics. They are simply playing I study the newspaper announcements intently, trying to wring some meaning from the photographs, but they are mute. Like those sepiaphotographs of young lieutenants who died in the First World War, these Denial by countries affected by AIDS
images demand an effort of imagination to evoke the underlying tragedy.
They show healthy young people, some wearing their mortar boards at
The tendency in the past has been for entire countries in Africa to deny the graduation, others in suits, open-faced and healthy. The likenesses have existence of AIDS. The reasons are numerous. From a mere economic been chosen not to illuminate tragedy or to define an epidemic, but to perspective, it can easily be understood that those in control of a country would preserve a memory of happier times. They, too, serve to conceal the awful, try to hide the true effects of AIDS. Who would invest in a country that is Why are we Losing the Battle Against AIDS? Why are We Losing the Battle Against AIDS? slowly but surely dying? From a psychological perspective, it is also But things have changed. One aspect I have found to be a tremendous understandable that a country's government would prefer to deny the impact of problem in Africa is a lack of respect for other’s privacy. This is often caused AIDS: To admit that you are losing the battle against AIDS may be interpreted by the living conditions of vast numbers of people in Africa, such as the lack as an admission of incompetence to rule the country. The denial of AIDS may of toilets (which means that people relieve themselves in public), the lack of also be linked to a historical perspective: People like Baffour Ankomah, bathrooms (which means that people often wash in rivers and streams) and the publisher of New African, consider AIDS as “U.S. biological warfare gone lack of bedrooms (which means that children often share their parent’s wrong.” Millions of Africans have long memories of Western evils: slavery, bedroom or at least that boys and girls, not necessarily from one family, but colonial exploitation, Cold War proxy battles and biological warfare tests also members from the “extended family”, share one bedroom). These people carried out by white-minority regimes. Ankomah considers AIDS as the latest grow up within a system where boys and girls, even after puberty, see each of these: a money-making hoax carried out by the United Nations at Africa’s other fully or partially unclothed on a regular basis, where they play together in the rivers unclothed, and where they consider all of this to be completely Many Africans also have an emotional reaction to the theory that AIDS natural. Little wonder that a recent survey done in Swaziland by UNICEF found originated in the blood of chimpanzees in central Africa, probably in eastern that, by 18 years of age, for all practical purposes, 100% of girls and 80% of Zaire in the late 1970s, and jumped to Africans. To many Africans, the theory boys have already had sexual intercourse.
sounds like old racist propaganda that linked black people and apes.
Denial by individuals affected by AIDS
A tremendous problem with which Africa has to cope is migrant labour.
Many people who are affected by AIDS are desperate to find something to People living in the rural areas need money for food. Because there are few blame for their condition other than their own behavior. To admit the most work opportunities in the rural areas, the men will often move out, either to common cause of AIDS would be an admission of an immoral life.
larger towns in their own country or to the mines in South Africa to earn more It is impossible to find a cure for a disease which seemingly “does not money. Some of these men visit their homes only over the Christmas season.
exist.” It is equally impossible to have compassion for the victims of AIDS if Some are fortunate enough to come home more regularly. For the rest of the the problem is still being denied to a large extent. Therefore, before one can time, they do not see their families.
seriously look for a solution to the AIDS problem, one will have to find ways South Africa’s former official policy of Apartheid contained laws forcing of bringing all parties to the point where they admit that AIDS does exist, that African people to live in certain restricted areas or homelands. Only those who it is largely spread through immoral living and that it is a killer disease.
had been issued with passes could enter and work in “White” areas. These lawscertainly contributed towards this situation. Men were often accommodated in 2. THE TYPICAL ATTITUDE TOWARDS SEX
hostels at their workplace, but their family members were not allowed to stayover in the same premises, as this would be against the laws of the country.
Sex, in general, is a taboo subject amongst the Africans. In the majority of Fortunately, the official policy of the country has changed, but the situation homes the subject is seldom if ever discussed in a healthy manner. Church remains, to a large extent, the same. A South African lady discussed this with leaders warn the youth to live morally correctly, but even these warnings are me some time ago and told me that her husband had forbidden her even to seldom accompanied by balanced teachings on the Biblical concept of sex and come and visit him in Johannesburg where he is working in a mine. But, she sexuality. In schools, children are taught the biological facts about sexual told me, she knows the reason for his attitude – he has another woman in reproduction, but these facts are mostly not accompanied by Biblical teachings Johannesburg! The need (sometimes greed) for money is forcing people to on the topic. From a very small age, children play sexual games with each make decisions that break down their family lives. Often even church leaders other, although it was traditionally frowned upon if a young man had have made a choice to live in this way. As family life breaks down, immorality intercourse with a girl before marriage. Why are We Losing the Battle Against AIDS? Why are We Losing the Battle Against AIDS? 4. PROSTITUTION
through the milk. So researchers are now proposing that women practiseexclusive breast feeding and abrupt weaning. That is, nothing at all except Closely linked to migrant labour is the problem of prostitution. Where breast milk for six months, and then an abrupt cutoff. Medically, this method married men live apart from their wives, the non-Christian, and even some has been proved to be effective in reducing the risk of mother-to-child Christians, make use of prostitutes or get a girlfriend living close by as a sexual transmission of HIV. However, especially in the rural areas, it is highly unlikely outlet. At mine and other hostels, so-called “sex workers” have an open door that this method will be implemented. In most, if not all sub-Saharan African to do business. In larger cities, “escort ladies” also have a roaring business. But countries, breast feeding is as normal as having a cup of tea. When a baby is then again, while people are poor, prostitution will always be an “easy” way to unhappy, the mother breast-feeds the child. This happens publicly, in church, earn big money. The girls are therefore only too eager to give themselves to the on the bus or wherever they are. To change this custom will not be easy. A total paradigm shift will have to take place in most cultures, which may be possibleon the long term, but definitely not on the short term.
The only other possible solution at this point, other than convincing a mother not to breast-feed at all or to practise exclusive breast feeding for six Another tremendous problem in the whole of Africa is that it has now months and then weaning abruptly, is to supply an antiretroviral drug to both become clear that HIV can also be spread through breast feeding. It has been mother and child. At present nevirapene seems to be one of the most effective found that 36% of the children with HIV were infected with the disease through drugs used for this purpose. A single dose is given to the mother at the onset of breast milk from their HIV+ mothers. The obvious solution is for mothers who labour and a single dose is given to the baby 48 to 72 hours after birth. Tests are HIV+ not to breast-feed their babies any longer. But things are not quite as have shown that there is a substantial decrease in the chance of a baby getting simple. For women staying in rural areas there is no other option than to breast- HIV from the mother if nevirapene is administered in this way.
feed their children. The choice is: lose your child through HIV or lose your Unfortunately a new problem has now arisen. In a medical research paper child (perhaps even earlier!) through malnutrition, typhoid, cholera or similar published in February 2003, it was reported that the most important resistance diseases. Milk formula is also too expensive for the majority of people living mutation to nevirapene has been detected in the breast milk of at least 70% of in the rural areas. Even if the milk formula should be given to HIV+ mothers women forming part of a test group in Zimbabwe. This means that nevirapene free of charge, it still has to be mixed with water. Where there is no pure water may not be effective for much longer to prevent mother-to-child transmission in the rural areas, it means that water from the rivers have to be used. However, of HIV. Breast feeding, central in the raising of a baby in most African upstream one will find cattle walking in the river and often these rivers are also countries, has now become one of the major problems in these countries where used by humans as toilets. Bilharzia is also common in virtually all rivers in AIDS are slowly but surely wiping out large parts of the population.
sub-Saharan Africa. Therefore, if milk formula is given to a baby, and the waterhas not been purified or boiled for a very long time, the baby will become illand can even die. A second problem is the cleaning of bottles. In the Western 6. USELESS METHODS TO PREVENT AIDS
culture all kinds of methods are used to ensure that feeding bottles are clean. Awhole training course will need to be undertaken in Africa if mothers want to In Swaziland, all kinds of innovative methods are presently being discussed ensure that they feed their children with sterilized bottles.
to stop the spread of AIDS. A major problems the country is experiencing is Researchers now recommend that African women with HIV breast-feed that more than half of all teachers in Swaziland are HIV+, according to some exclusively for six months, using techniques that minimize cracked nipples, sources. (Similar reports also exist from South Africa). Sexual intercourse then abruptly wean. Doing so could reduce the HIV transmission risk to as low between teachers and school children seem to be common. The teachers have as 6 percent. Anything else given to an infant – water, bits of porridge or money and are able to pay the school girls for their services. In a feeble attempt cooking oil (often given to combat constipation) irritate the lining of the gut, to try and stop this practice, a new law has been introduced in Swaziland, increasing the possibility that the baby’s body will absorb the HIV virus whereby girls will not be allowed to wear dresses or skirts to school that sit Why are We Losing the Battle Against AIDS? Why are We Losing the Battle Against AIDS? above the girl’s knee. The rationale behind this is that government feels that if household detergents or antiseptics, in their vagina prior to intercourse in order the girls’ legs are not showing, then the teachers would not be interested in the to prevent wetness of the vagina during intercourse. They claim that this girls any longer! Serious discussions are also being held in parliament to produces a “hot, tight, and dry” environment, which their men find more consider making forced sterilization a law for all HIV+ people. How this will pleasurable. In a survey conducted at various Family Planning Clinics in help in the fight against AIDS was not said. It has also been suggested that all Zambia, findings revealed that 25% women claimed insertion of substances HIV+ people should wear some kind of mark (similar to the yellow stars worn ranging from dry cloth, chemicals such as dettol, salt, flagyl tablets to herbs to by the Jews in Germany during the Second World War) in order to identify minimize wetness which the men resented. In the survey, 85% of the men them as carriers of the virus. In South Africa heated debates have been preferred dry sex. On the other hand, it was found that only 15% women conducted in order to prove that AIDS is not caused by HIV, but that the actual claimed to prefer dry sex. Most found it painful and only performed it to satisfy cause is poverty. If poverty could be eradicated, then AIDS will also vanish. It their husbands, and to prevent them from finding other partners outside is clear that people are at a loss to know how to handle the situation.
marriage. Due to their financial dependence on men, women are unable tonegotiate safety, type or pleasure of sex. Most women do not enjoy dry sex but 7. THE MYTH OF “SAFE SEX”
While this illustrates the point that women have very little say about their Officially, people are told that the ABC method should be followed in order sexual lives, the further result of this practice is that, if condoms are still used, the risk of the condoms breaking during intercourse becomes much greater. In the survey done in Zambia many participants complained of condom breakage in dry sex experiences. Also, glaring differences were found when comparing HIV rates to similar communities where wet sex was more common. In the In Africa I have found that only the last method is seriously propagated, group practicing dry sex, there was a 20% HIV prevalence as opposed to 10% more commonly known as “safe sex.” In spite of huge promotional campaigns to convince people to use condoms, even to the extent where bill boards were Violence against women within marriage relationships are common. Where erected in South Africa with the national flag on it in the shape of a condom, countries are in a state of war, rape is also much more common, as this is often the number of people contracting AIDS are still growing exponentially. There used as a method of intimidating the enemy. Even in countries not ravaged by are many reasons why this method is not working. The main reason is probably war, rape, including the rape of children under the age of sixteen, have a cultural one: In Africa the use of a condom is often compared to bathing with increased tremendously over the past few years. Child abuse is also occurring your socks on. It is just not part of Africa’s culture to use condoms during Another problem is the unreliability of condoms. Some medical reports In articles and comic strips in which the use of condoms is promoted to consider condoms to be around 96% reliable as a birth control method. As a address the AIDS problem in Africa, women are encouraged to deny sex to men method of protecting someone from HIV, reliability will definitely be much if the men are not willing to use a condom. In the African culture, where lower. There are two reasons for this: ignorance of the correct use of a condom women are taught from young age that they have to respect men. Where they contributes towards the ineffectiveness of this method, and the poor quality of are traditionally considered to be inferior to men, it is extremely difficult for condoms “dumped” on the African market results in more frequent breakage.
them to apply this in practice. In extensive studies done among people in Good quality condoms are fairly expensive. Even amongst those, a certain Africa, it has been found that a woman has very little say about her sex life – percentage of breakages and slippage are reported. Sex with a condom is undoubtedly preferable to sex without a condom, if you are not 100% sure of This can clearly be seen in a practice known as “dry sex” and which has the HIV status of your partner, but it cannot be considered as a 100% safe been reported in many countries in Southern Africa, including South Africa, Zimbabwe, Malawi, and Zambia. Many women will insert substances, such as Why are We Losing the Battle Against AIDS? 8. IS THERE AN ANSWER TO THIS PROBLEM?
C People from a Western background need to understand the disastrous C People from an African background need to understand more about the causes of AIDS and take responsibility for their part in the spreadingthereof.
C Christians will have to be taught that the acceptance of salvation in Christ needs to be demonstrated in a Godly life.
C God’s will for marriages should be explained in a way that will really speak C God’s will for the family should also be addressed effectively.
C The problem of migrant labour needs to be addressed and people will have to be convinced that a choice for a lower salary but a more Godly familylife is a worthwhile choice to make.
C Recent research has shown that most Christians (more than 80%) accept Christ as Saviour between the ages of 4 and 14. If we want to win the battleagainst AIDS, then this is the age to start with.


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