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Siyayinqoba Beat It! Episode 18 –

HIV in Africa

2004 statistics tell us that sub-Saharan Africa is the region of the world most affected by HIV/AIDS. 25.4 million people were living with HIV and AIDS, there were around 3.1 million new infections in 2004 and 2.3 million people died from HIV/AIDS-related causes in that year. More than 12 million children had been orphaned. The Siyayinqoba support group explored these serious challenges with HIV activist, Believe Dhliwayo, who shared the Zimbabwean experience of poor resources, denialism and stigma. We also learnt about creative steps being taken in Botswana to address the epidemic from the Botswanan President Festus Mogae.

Jason Wessenaar: Kgotsong re ya le amohela mona ho Siyayinqoba beat it! support group. {Sesotho} [Hello and welcome to the Siyayinqoba support group.] My name is Jason. In the Siyayinqoba Support Group we are all living positively with HIV. Each week we get together to talk about issues that affects our lives with HIV from leadership in the fight against HIV to caring for people who are sick. USiyayinqoba nguhlelo lwakho lokuphila kangcono ne HIV. Uma uphila negciwane leHIV [Siyayinqoba is your guide to better living with HIV. If you are living with HIV] or you have a partner, a friend, a family member this programme is for you. This week we are talking about HIV and AIDS in Africa. The sub Saharan region is the world most affected by HIV and AIDS. An estimated 25.4 million people are living with HIV/AIDS. And approximately 3.1 million new infections occurred in 2004 alone. In just the past year the epidemic has claimed the lives of an estimated 2.3 million people in this region. Around two million children under the age of 15 are living with HIV and more than 12 million children have been orphaned by AIDS. Botswana is one of the countries that has been hardest hit by the epidemic. In 2004 there was an estimatied 260 000 people in Botswana living with HIV. This in a country with a total population of 1.6 million gives Botswana a prevalence rate of about 16%. The second highest in the world after Swaziland. Life expectancy is only 39 were it would’ve been 72 years if it was not of AIDS. To help us discuss this topic we’re joined by the Director of HIV Partnership for Eastern and Southern Africa Doctor Christine Sadia, Doctor Sadia is from Action Aid a UK based charity organisation fighting poverty and HIV in Africa. Welcome Doctor Sadia. Ali Nuwa Ssesanga is also joining us for this discussion, welcome Ali. South Africa is affected with what happens in Zimbabwe we know where ever there is forced removals; disruption people are more exposed to HIV infection. The Siyayinqoba team interviewed one of the AIDS activist in Zimbabwe Believe Dhliwayo who lives in Harare and works with support groups. Let’s meet Believe.

Believe Dhiliwayo

Harare, Zimbabwe

Believe Dhliwayo (AIDS Activist, Zimbabwe): The role of the leadership in Zimbabwe with regards to HIV, we have reached a stage whereby there is denial at a highest level. I have been living with HIV for the last 11 years and this is my 11^th year. In 2004 166 people died of AIDS related deaths. But is also a known fact from reliable sources that we are having 50 people dying only in Harare by day. Basic raw materials that are needed just to make pain killers they are not there. That is how the serious economic situation, also being culminated by I think international isolation which has not yet embarketed on politicians but embarketed on the poor person living with HIV. Some of the things that we are actually doing to deal with stigma and poverty amongst people living with HIV and AIDS is we are encouraging of help projects. In Zimbabwe we have got a number of people who are policy makers who are down most probably of HIV related illnesses but not anyone of them has come out yet to say they a suffering or they are affected with HIV.

Support Group

Jason Wessenaar: The four countries that are sort of the highest, that have the highest statistics which are the neigbouring countries South Africa, Botswana, Lesotho, Swaziland and Zimbabwe for that matter. How can South African or how can South Africa work together with them to assist in whatever? Why, because we are affected with whatever happens in those countries, you know people move to those countries to our country and people move and immigrate to those country and people are exposed to HIV with the movement to one country to another.

Dr Christine Sadia (Action Aid International, Kenya): I think I would like to say the vibrancy of the movements of people living with HIV or the vibrancy of civil society I think need to be strengthened in this region. Because it was a punch then we that knowledge or skills people can have cross border exchange of views, people can say what works within the conflict situation you can get it from Eastern Africa were they have told you for a long time that they have been in wars, Sudan is the same, Somalia is the same and we have documented that during a conflict or when people are fleeing whether internally displaced people refugees or migrant that the HIV up such is higher.

Ricardo Moses: In your country do you work with traditional healers, what role does traditional healers play, do you work very close with traditional healers?

Dr Christine Sadia: The traditional healers for example we work with them very closely and the system has recognised that they have a role because whether you like it or not traditional healers are recognised and they are respected in their community it’s a social structure that has respected them very well. So what we did for the first instance was to help them within the practices so that they will give them the new technology. For example the traditional birth attendance, who used to deliver 80% of women in my country, what we used to do we used to give them packages so that they could wear gloves for any woman for cutting the ambical cord they have one razor blade we have already put the cord in spirit and tied it there. So we sort of like use their skills but modernise their skill so that they are hygienic and they will not pass the virus form one person to another.

Jason Wessenaar: We talk more about HIV and AIDS in Africa after this break. Don’t go away.

Jason Wessenaar: Mmuhi re ya ho amohela hape mona ho Siyayinqoba Beat It! Support Group {Sesotho} [Welcome back to the Siyayinqoba Beat It! Support Group] – the programme for everyone infected and affected by HIV. But first to find out what we can learn from Botswana’s experience the Siyayinqoba team visited Gaborone in Botswana, were the President Festus Mogae was kind enough to talk to us. Let’s go to Botswana.

Botswana's example

Gabarone, Botswana

Festus Mogae (President of Botswana): Once we found out that we are one of the most infected country we draw it to the attention of the nation that we are in trouble that we have to do something about it. People were testing but not as many as we hoped and we felt that the constrained or the stigma people pointed at people, visiting, counselling and testing center. So if you want to test for yourself in these special clinics people pointed a finger and said: “Ja he must be HIV positive” even when you are not and therefore we thought of overcoming that. That is way we decided on routine testing. However if in spite of all this good intentions in spite of all the things that we think are good for you, if you don’t want to be tested then yes we will not.

Cynthia Leshomo (Miss HIV Stigma Free): Leina lame ke Cynthia Leshomo. Ke itsile ka seemo same sa mogare. Erile ka di 26 Hlakola 2005, be ke koronwa Miss HIV Stigma Free. Tota ele tiro yame ke le Cynthia ngwaga o ke gore ke rute bana gagologolo baba mo kgatong ya sekolo, ba amogele batho ba ba tshelang ka HIV le AIDS. Ka gore tota hela ke lemogile gore bana ba banyenyane ba, le bona ba kgona go stigmatize bana ba bang. {Setswana} [My name is Cynthia Leshomo. I’m open about my HIV status. On 26 February 2005, I was crowned Miss HIV Stigma Free. My responsibility is to teach children, especially at school level, to accept people living with HIV and AIDS. Because I’ve noticed that even little children stigmatise other children.] Today we are going to talk about stigma. Do you understand stigma, we still have a long way to go and fight stigma associated with HIV and AIDS. Gape le mogong tota hela ke buella, ke emetse gore ke buelle batho ba ba tshelang ka mogare ka gore ba santse ba tshaba, ga ba batle gore mantswe a bone a utlwale ga gologolo mo Botswana.Ke solofela gore tota hela nkabe re tshwana le ma helo a tshwanang le bo Afrika Borwa mo eleng gore re ka dira go re mantswe a rona a utlwale.Ke lemogile gore batho ba ba ntsi ba ba tshelang ka mogare ga re bereke. {Setswana} [I speak out for people living with HIV because some of them are still afraid, they don’t want their voices to be heard especially in Botswana. I wish our country was like South Africa we can really make our voice to be heard. I’ve have realized that most of us people living with HIV/AIDS are unemployed.] Why can the government or the ministry or whatever can bare involver, there should be greater involvement for people living with HIV/AIDS, ha o ya ko bookelong o tla ithlela go nale shortage ya baoki.Ga ke re gore re kanna baoki gobane ga ra katisiwa gonna baoki. Mme hela re ka tshameka role ya go thlokomela batho ba ba tshelang ka mogare gobane. {Setswana} [you go to our hospitals you will find that there is a shortage of nurses. I’m not saying we should be nurses because we are not trained to be nurses. But we can play a role in looking after people living with HIV because,] we bare the witness of living with HIV and AIDS. Ha rentse re ba thlokomela ga go tshwane le motho o mong o kaseke a ba he lerato. {Setswana} [If we care for them it will be better than a person who doesn’t have compassion], we are the right people to give the newly diagnosed the lerato lewu [that compassion that care] they need, that support that care because we are living with it.

Festus Mogae (President of Botswana): Ke dirile jalo ka gonne ke ne ke bona gone gore go itse seemo sa gago go mosola, gomolemo. Ka gore one mogare hela ja ka mathata a mangwe kana malwetse a mangwe. Ga o ka wa itse seemo sa gago, ere ha o tlhoka thuso wa kgona go e bona ka bonaka. Go ra gore o nale tjhono e botoka ya go tshela lobaka lo lo lele. {Setswana} [It’s important for people to know their status because it’s a good thing. HIV is just one of many other illnesses. If you know your HIV status, you will be able to get help immediately. This means you have a better chance to live longer.]

David Chizao Ngele: Leina lame ke bediwa David Chizao Ngele.Ke bereke mo Botswana Network of People Living with HIV/AIDS.Mathata a re lebaganeng le one ba re tshelang le mogare wa HIV ka Botswana ka bophara:Santlha ,ke stigma le discrimination.E sampe e le bothata mo gompieno mo.Sabobedi ,ke banna ,banna ba few mogo HIV/AIDS.Di support group tsa rona di nale,akere batho ba 25,o ka ithlela maybe go nale monna ale mongwe kana banna ba babedi wa bona.So e sampe e le bothata.Gore gobaneng banna ba sa tsene mo HIV/AIDS issues. {Setswana} [My name is David Chizao Ngele. I work for Botswana Network of People Living with HIV/AIDS. The problem we face as people involved with HIV issues in Botswana: Firstly, is stigma and discrimination. Those are big problems here. Secondly, we have very few men who are involved with HIV/AIDS. In our support groups when we have, for example 25 people, only one or two of them are men. So that’s still a problem. We are concerned about men not involving themselves in HIV/AIDS issues.]

Festus Mogae (President of Botswana): Ke ne ke dira jalo ke go basupetsa gore nya kana sose ke bolwetsi hela jaka bolwetsi le bongwe. Ke mathata a re thlagetseng ga re itse gore bo re tswela kae, mme ga goreye gore ha o nale mogare ga o tshwane le batho ba bang. Janong ke sone ne ke dira jalo. Ele gore ke mo seemo se ne rele mo go sone rona Batswana. {Setswana} [I tested publicly to show people that HIV is just one of many illnesses. It’s a challenge we are facing with, but it does not mean when you have HIV that you are different from other people. That’s why I tested publicly. That’s the situation we were faced with as people of Botswana.]

Support Group

Jason Wessenaar: Having watched that insert Doctor Sadia, what can we learn from Botswana?

Dr Christine Sadia: The lessons that you have seen from that insert are very striking in terms of political good will, I would like to mention one of the ingredients of an up take of an HIV/AIDS response is the political good will. You can see where the President is talking, is heading his people it comes from his heart and he has also demonstrated it, he wants to be the people who have tested. People take it like the President believes in it and then the people follow their leader and that opens the space for also the technocrats to be serious about their planning and about the implementation of the programme and I think that is very important.

Prudence Mabele: The former President of Zambia u Kaunda’s son died of HIV and AIDS and one of the things that we have seen he was ready to talk to the people in Zambia about that and also just to go to other countries and disclose and talk about it. And that has shown that things changes if political are also doing something.

Jason Wessenaar: We spoke about political leadership wellness in terms of what we can learn because South Africa has lacked greatly in that respect but what other lessons you think we can learn as far as treatment, care or maybe prevention programmes.

Dr Christine Sadia: What I like about Botswana’s experience apart from the fact that stigma there is still denial and stigma, which has not opened the avenues for people to do testing, but you can see they have gone to the route of routine testing but with an option of opting out. So you can opt out but the opportunity has been provided. The other thing they have gone in massive health system infrastructural development, so there is a refinery laboratory right now and they put them at strategic places and they even use the courrier system to dispatch the information once you have been tested to the refinery laboratories and everybody that the criteria for inclusion for the treatment is eligible you are assured of the treatment.

Ali Auwa Ssesanga (AIDS Activist Uganda): What I’m seeing in Botswana is a step ahead as to fight HIV and AIDS currently but also we can’t look at it now where the percentage has raised high, we can ask ourselves a question before what was happening, what was the government was doing before because I was in school around ’86, when President Yoweri Moseveni to fight HIV and AIDS in Uganda. He not sit in his office to command; he came down to the schools, to the local community.

Prudence Mabele: Ko Lesotho go nale mathata a mangata .Batho ba phelang ka HIV bantse ba le stigmatised {Sesotho} [There are still a lot of problems in Lesotho as well, because people living with HIV are still stigmatised] and they are isolated and they are scared to even talk about it. Even, other were mentioning that even treatment is not there and that country is such a challenge because I know quite a lot of friends that comes to South Africa so that they can get their things right because they are scared to be seen in Lesotho.

Lihle Dlamini: But even with us Prudence, e-South Africa nathi besinaloyo nkinga ukuthi we are afraid of stigma [in South Africa we were faced with problems of stigma] not many people were coming out with their HIV status up until i-roll out yama antiretrovirals [the roll out of antiretrovirals]. It has played a major role ekuthini abantu baphumele obala, but I think nathi even though sinaso i-stigma not as much as Botswana iyifasile [in encouraging people to come out with their HIV status. Even though in South Africa we suffer stigma, it’s not as much as Botswana]. And I think we have a lot to learn form Botswana in combating stigma as well as much as Botswana has more stigma than us, I like the idea of kube khona uMiss Stigma Free. It makes abantu bakwazi ukuthi baphumele obala ne-pride ukuthi {isiZulu} [having people like Miss Stigma Free. It encourages people to come out with their HIV status with pride ukuthi I’m living with HIV]; I’m living with HIV.

Jason Wessenaar: Re bua hape ka HIV/AIDS mo Afrika ha re kgutla mabenkeleng. {Sesotho} We talk more about HIV/AIDS in Africa when we come back from the break. Stay tuned.

Jason Wessenaar: Mmuhi re ya ho amohela hape mona ho Siyayinqoba Beat It! Support Group {Sesotho} [Welcome back to the Siyayinqoba Beat It! Support Group] – the programme for everyone infected and affected by HIV. Sub Saharan Africa, or region, given the prevention messages, care support messages; are we at the point or are we heading into a direction we were able to cap the epidemic.

Dr Christine Sadia: We need to domesticate what happens globally, what has improved as a best practice globally but domesticate to suit our own context. It has reached a point were people begin to think that because Africa, the white people in terms of Europe ask me, what is wrong with your people, because maybe they think Africa likes sex more than themselves. To the contrary I have been there for three years I have lived there for three years, they have more sex there but the difference is their sex is protected sex. African man will tell you if I have married you, you’re my wife sorry I will not use a condom because I have paid, here you call it lobola, so what are we saying it is a change of mind set, is a change of attitude, respect for one even if it’s your wife, you may have paid lobola but please respect the human person.

Prudunce Mabele: Nako e go nale conference ko Nigeria ya OAU [When there was a OAU conference in Nigeria] all the African leaders were there and I think that is were they started that thing of globally fund ebile ha o ka sheba, di presidents tsa mafatshe a Afika kaofela a na ale mo and South Africa a ne a seko ntate Thabo Mbeki.Ntho eo e ne e le concern konna hobane ne e jwetsa fela a whole lot of story ka go re even though re ka re re a leka re na le di resources hare serious ka anything, re etsa fela. Empa le mo he, lefatshe engwe le engwe ene e senola di statistics e bua ka gore? Le mafatshe a mang a mangata o ne o bona competition ne bautlwa kgatello. Ke gopola hantle Nigeria e buile ya re retlo qala treatment retlo lata medication ko India, ene ba e entse ka nako e o, ba ne ba matha. Ene rona ha o sheba, minister wa rona wa Health one a le teng.Ene o mmona gore o nale that arrogance ha a batle le ena go bontsha hore o nale something to give. {Sesotho} [and if you look at it, all the presidents of other African countries were there but South Africa wasn’t represented, Thabo Mbeki wasn’t there. That was a concern to me because it told me a whole lot of story because even though we try and have resources we are not serious about anything, just doing it for the sake of doing it, but even in that every country was disclosing their statistics and how they planning for what? And many other countries there was competition you could feel the pressure. I remember when Nigeria said they’ll be starting treatment and getting from India, and that’s what they did immediately, no time was wasted. And also, our Minister of Health was there. She was arrogant and didn’t want to show what she had to offer.]

Ali Auwa Ssenga: If the ANC can lead the treatment things will come right but the moment they say we don’t know Mathias Rath, I don’t know he’s right, he’s wrong things will never come right. Some people who wait for the President to talk we have seen it, we are be driven by political leaders, unless the President talks they will not listen, unless the Deputy President talks they will not listen, how much you talk, how much to treat they will not listen problem we are having in Africa, HIV and AIDS needs sensitizing, educating the local people.

Jason Wessenaar: Re ya leboha Dr Sadia le wena Ali, support group le lona ba bohedi mo mahaeng. Kajeno re ithutile hore se se etsahalang mafatsheng a mang ,ha holo ha holo a pela Afrika Borwa,se ya re ama.Re lokela ke ho ikamahanya ho lwantsha HIV Afrika bophara.Naheng tse tshwanang le Lesotho ,Swaziland le Afrika Borwa ke tsona tse fumanang basebetsi ba merafong le ba di polasing,me HIV e namme naheng tsena.Re lokela ke ho kopa thuso mmusong wa rona ka fumaneho ya di ARV le diteko tsa madi mafatsheng a kantle. {Sesotho} [Thanks to Dr Sadia, Ali, the support group and the viewers at home. Today we’ve learned that what happens in other countries, especially in Africa, affects all of us as well. We need to commit ourselves to fighting HIV in the whole of Africa. Countries like Lesotho, Swaziland and South Africa, are the countries where mine workers and farm workers are mostly found and HIV is very high in those areas of work. We need our government to help us by providing ARVs, and blood testing services from other countries.] We appreciate your letters so please keep on sending them in, this week’s letter is from KG in Blantaya in Malawi. He says:

I saw Siyayinqoba in SABC Africa. I’m one of the people affected by HIV and AIDS I have lost many people from this disease. Many people in my area are not open about this disease because even when dies they do not talk about it they remain silent. I was very surprised to hear you guys say that you are living positively with HIV, I have learnt a lot from you. I will also be with you guys. You keep my life going, safe indeed together we can Beat It!

Thank you KG for your letter Siyayinqoba is here for you and for other people living with HIV all over Africa. We thank you for all the letters we have received keep them rolling in. We hope that you have enjoyed the show and you are feeling the Siyayinqoba Spirit that together we can Beat It! If you have any questions, comments, views about the show please contact us on P.O. Box 62, Muizenburg, Cape Town, 7950, or go log on to our website, www.beatit.co.za or you can mail us on info@beatit.co.za. Join as again next week in the Siyayinqoba Beat It! Support Group. Until then, stay health and stay positive.

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