AFRICA: Africa World Press Guide

compiled and edited by WorldViews

AIDS IN AFRICA
Models of Community Support

The issue of AIDS in Africa is a troublesome one for educators and for those who struggle to change negative, stereotyped images of Africa. Should AIDS be considered at all in educational programs about Africa? Is it just one more ex ample of the too-easy connection that is made between Africa and apocalyptic crises? Africa educators ask: If you were studying the Americas or giving a course on one or another country in Europe would you include a segment on AIDS? If not, the educators counsel, then it is not fair to isolate Africa in this regard, no matter how grave the crisis.

There is also a concern about the unreliability of AIDS-related statistics. As Doctors David Sanders and Abdulrahman Sambo observe in their article, "AIDS in Africa," in AIDS, Ethics and Religion: Embracing a World of Suffering (Overberg 1994), there is little precision in the number of HIV and AIDS cases reported to the World Health Organization (WHO) from the African continent. "Underreporting," they write, "which is common, is due mainly to lack of reliable data and government sensitivity--d ue to concern for the presumed negative effects on tourism and investment as well as sensationalized (and often racist) reporting of the epidemic" (p. 47).

A final--and very troubling--issue is that of racism. The contention that the Human Immunodeficiency Virus (HIV) had its origins in Africa is denounced as racist by some authors and AIDS activists. AIDS, Africa, and Racism (Chirimuuta a nd Chirimuuta 1989) and Blaming Others: Prejudice, Race and Worldwide AIDS (Sabatier 1988) are two books that challenge readers to reexamine the accepted wisdom on the origins of the virus. However troubling the AIDS issue is for Africa educators, researchers, and activists, the fact remains that the AIDS crisis has had a terribly disproportionate impact on the people of Africa. In 1996, the World Health Organization (WHO) estimated that of the 23 million HIV-positive adults worldwide, over 14 mil lion were in sub-Saharan Africa. United Nations figures estimate that another nine million will die as a result of AIDS in the 15 sub-Saharan African countries by 2005. Clearly the spread of AIDS in Africa is a crisis that merits serious study and sensiti ve concern. No one is helped by ignoring this crisis out of fears--no matter how well-founded--that discussion of the issue will be mishandled by some educators or misunderstood by others.

The resources described below document the nature and extent of the AIDS pandemic in Africa and situate the crisis in the broader context of the spread of AIDS worldwide. The resources also highlight--and this is critical--the innovative and effective ways that Africans are responding to this health challenge.

Three reference books that offer general overviews of the worldwide spread of the AIDS pandemic are

None of the books devotes particular attention to the spread of AIDS in Africa, but the data they provide are invaluable for setting the AIDS in Africa crisis in a world context.

AIDS in the African context

Three book-length studies examine the AIDS crisis in the African context:

AIDS in Africa and the Caribbean ( Bond et al. 1997) contains ethnographic studies from African and Caribbean nations. Facing Up to AIDS features articles by economists, demographers, and health planners and concentrates its geographical focus on South Africa and Zimbabwe. AIDS in Africa deals with the social and economic consequences of AIDS in Africa, with special reference to Uganda. Edward Green's AIDS and STDs in Africa critically analyzes various AIDS control progra ms in Africa and argues that "some sort of collaborative action program involving traditional healers is necessary if we wish to significantly impact the spread of AIDS and other STDs in Africa."

In 1994 the Department for Economic and Social Information and Policy Analysis of the United Nations released a 72-page study of the epidemiology and the demography of HIV and AIDS in Africa: AIDS and the Demography of Africa. The UN report fea tures country profiles of fifteen sub-Saharan nations. Each profile contains a one-page narrative overview and a table of demographic indicators (from 1980 to 2005).

Geographer Peter Gould focuses a chapter on Africa ("A Continent in Catastrophe") in his book The Slow Plague: A Geography of the AIDS Pandemic (Gould 1993). Gould argues that we should "throw away the supposed precision of reported statistics [about AIDS], hold onto our commonsense" and analyze how the AIDS pandemic has spread in Africa (and elsewhere) both spatially and temporally."

Anne V. Akeroyd discusses several other books concerned with debates relating to the extent and possible future development of HIV/AIDS in Africa in an article entitled "HIV/AIDS in Eastern and Southern Africa" in the Review of African Political Eco nomy (no. 60, pp. 173-184, 1994). Among the books reviewed are Facing up to AIDS: The Socio-Economic Impact in Southern Africa (Cross and Whiteside 1993) and Women and AIDS in Rural Africa: Rural Women's Views of AIDS in Zambia (Mwale and Burnard 1992).

Case studies of local initiatives to combat AIDS in five African countries are contained in Community-Based AIDS Prevention and Care in Africa: Building on Local Inititatives (Leonard and Khan 1994). The countries profiled are Kenya, Tanzania, Uganda, Zambia, and Zimbabwe.

Elizabeth Reid's HIV and AIDS: The Global Inter-Connection (Reid 1995) contains numerous personal stories about how individuals and communities are living with and working to stop the spread of the virus in Kenya, Lesotho, Nigeria, Tanzania, Ug anda, Zaire, Zambia, Zimbabwe, and in other countries of the world.

AIDS-related issues in Africa

Children:
Vol. 20, Nos. 2-3/93 of Children Worldwide (International Catholic Child Bureau 1993) was devoted to an international survey of children and AIDS. Included in the coverage of Africa were reports entitled "The Fight against AIDS in the Socio-Cu ltural Context of Africa," "Prenatal Transmission of HIV in Africa," "TASO: Living Positively with AIDS," "AIDS Orphans: Problems and Solutions," and "Anti-AIDS Clubs [in Zambia]."
Development
The Hidden Cost of AIDS: The Challenge of HIV to Development (Panos 1992) makes several critical points about the relationship between HIV/AIDS and development. The first is that HIV/AIDS is only secondarily a health problem. "The epidemic is driven by social and economic factors which make some individuals more vulnerable to infection." The second point is that poverty fuels the spread of HIV/AIDS. "Communities struggling with inadequate health facilities, high levels of illiteracy, and low i ncomes are often more at risk." (Quotes found on p. 153.) CAFOD, the overseas development agency of the Roman Catholic Church in England and Wales, produced an "information pack" in 1993 that was designed to help church audiences situate the AIDS crisis within the broader context of development: AIDS and Development.
Women
Women and HIV/AIDS: An International Resource Book (Berer and Ray 1993) describes the impact of HIV/AIDS on the health, sexual relationships, and reproductive rights of women in Africa (see references throughout the book) and contains case st udies of women with AIDS in Nigeria, Tanzania, Rwan_da, Uganda, South Africa, and Zimbabwe. Examples of creative and effective responses to the HIV/AIDS crisis by women in Africa are found in Brooke Grundfest Schoepf's article, "Action-Research and Empowe rment in Africa," in Women Resisting AIDS (Schiences (Princeton, N.J.): AIDS in Africa: Living with a Time Bomb and Isingiro Hospital ;
  • Media for Development Trust (Harare): More Time ;
  • TVE Distribution and Training Centre (Zeist): At Risk and The Orphan Generation .

    Strategies for Hope

    Strategies for Hope produces resource materials that describe the pioneering experiences of African nongovernmental organizations in meeting the challenge of AIDS. Produced with support from various British relief agencies, the resources highlight community-based forms of care, counselling, and support for people with AIDS and their families.

    Booklets

    • From Fear to Hope: AIDS Care and Prevention at Chikankata Hospital, Zambia (Williams 1992)
    • Living Positively with AIDS: The AIDS Support Organization (TASO), Uganda (Hampton 1991)
    • AIDS Management: An Integrated Approach (Campbell and Williams 1992)
    • Meeting AIDS with Compassion: AIDS Care and Prevention in Agomanya, Ghana (Hampton 1991)
    • AIDS Orphans: A Community Perspective from Tanzania (Mukoyogo and Williams 1993)
    • The Caring Community: Coping with AIDS in Urban Uganda (Williams and Tamale 1991)
    • All Against AIDS: The Copperbelt Health Education Project, Zambia (Mouli 1992)
    • Work Against AIDS: Workplace-based AIDS Initiatives in Zimbabwe (Williams and Ray 1993)
    • Filling the Gaps: Care and Support for People with HIV/AIDS in Côte d'Ivoire (Williams et al. 1995)

    Videotapes

    • TASO: Living Positively with AIDS. A two-part (55 minutes) videotape on the work of The AIDS Support Organization (TASO) in Uganda.
    • The Orphan Generation. A 50-minute video about community-based care and support for children orphaned by AIDS.

    Strategies for Hope materials are available from TALC, P.O. Box 49, St. Albans, Herts AL1 4AX, England or, in Kenya, from Health Education Network, AMREF, P.O. Box 30125, Nairobi, in Tanzania, from AIDS Project, AMREF Tanzania, P.O. Box 2773, Dar es Salaam, and in Uganda, from AMREF Uganda, P.O. Box 51 , Entebbe.

    African Charter on Human and Peoples' Rights

    AIDS and the African Charter (Jallow and Hunt 1991), an occasional paper from the African Centre for Democracy and Human Rights Studies (Banjul, The Gambia), outlines the nature, extent, and impact of AIDS in Africa and then reviews some provisions of the African Charter on Human and Peoples' Rights (see human rights chapter below) that are relevant to the subject.

    The authors note that international human rights law usually grants rights to individuals and imposes duties on states. "One of the distinctive (and contentious) features of the African Charter," they write, "is that it expressly p laces duties on individuals. The Charter, for example, expressly imposes a duty on individuals not to discriminate and 'to maintain relations aimed at promoting...mutual respect and tolerance'. Given that people with AIDS are constantly subjected t o discrimination and intolerance,"Jallowand Hunt conclude, "it is salutary to have these duties, even if they are legally unenforceable, re-affirmed in a major international human rights instrument" (pg. 22).

    A Personal Story

    An inspiring story of one Ugandan woman's encounter with AIDS is told in We Miss You All. Noerine Kaleeba: AIDS in the Family (Kaleeba et al. 1991). Kaleeba, a physiotherapist and mother of four, recounts her struggle to come to terms with her husb and's AIDS-related suffering and death in mid-1983. Kaleeba speaks forthrightly about her decision to come "out in the open" about her husband's disease, about the "uncomfortable and distressing" experiences she had with hospital staff, and about the diff iculties that she and Chris had had in their marriage relationship. Shortly after Chris died (on January 23, 1987), Noerine Kaleeba joined together with 16 friends, 12 of whom had AIDS, to establish the AIDS Support Organisation (TASO) in Kampala, Uganda.


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