All quiet on the Aids front…

February 15th, 2008

The combination of the quiet festive period and the focus on the ANC’s party conference at Polokwane has meant that there has been scant focus on the AIDS question and the issues that surround it. This is disappointing to report, since the drop in AIDS reports seems to have started directly after World AIDS Day, on December 1st, on which the AIDS benefit concert – the Nelson Mandela 46664 concert – was held.

Are we then to assume that having the attention shifted to AIDS on that day led to the feeling that the issue had been dealt with, and had received enough media attention for the time-being? Perhaps the view is not so cynical, but it does raise questions as to the value of having an “AIDS day”. Does the event allow the media, and people in general, to focus their attention on one day, and then discount the AIDS question thereafter, having “done their bit”?

There was, however, one noticeable exception, when the story “HIV+ dancer sent back to SA” was printed on 18 January. This concerns an unnamed dancer that was set to perform in the U.S.A in the popular “African Footprint” production, only to be told by U.S. authorities that he is forbidden to enter the country on account of having “a communicable disease”, or more specifically that he was HIV positive.

It seems that, although the U.S.A seems to constantly remind us about democracy and human rights, it is lagging behind South Africa in its policies regarding HIV and AIDS sufferers. While it is pointed out by the producer of the show, Richard Loring, that the dancers have to use sticks during the performance leaving them susceptible to cuts, one must ask whether the implication is that all HIV positive dancers are to be similarly barred, since cuts are a realistic eventuality in any dance routine. The line has been clearly drawn by the U.S. foreign office regarding this dancer, but what are the implications for HIV-positive performers across the world?

It appears, at least, that the reporting of the incident on our shores indicates surprise at the exclusion of the performer. This suggests a more accepting and less stigmatised view on HIV and AIDS sufferers.

Matthew van Onselen

An Old Truth

November 9th, 2007

This week saw the reemergence of an old and frustrating truth: Mbeki ‘still AIDS dissident’. According to Mark Gevisser, the author of a new biography about Mbeki, the President still maintains that there is doubt over the link between HIV and AIDS, and sees the scientific conventions concerning AIDS couched in racist and colonial paradigms.

There has been little press coverage of Mbeki’s controversial understanding of the HIV/AIDS epidemic ever since the decision was taken to “withdraw” him from the debate. By this it is meant that the negative media coverage of the outdated and unhelpful constructs that Mbeki was purporting were harming the ruling party’s reputation, since the public already had concerns over the outdated and unhelpful attitude of Health Minister Manto Tshabalala-Msimang.

Although the reemergence of this topic might be painful to those working in the fight against AIDS, it might simultaneously be a sign of encouragement. The fact that media exposure and international condemnation led to the President having to bite his tongue, while everyone else began finding answers to the crisis, means that democratic forces made significant ground in the fight for a rational and empirical approach to the HIV/AIDS crisis.

The President seems unlikely to alter his personal views regarding HIV and AIDS, but thankfully this no longer means an inevitable regression in the struggle to save the lives of people living with HIV/AIDS. However, one should be mindful of the positive impact that the country is being deprived of because of Mbeki’s stubbornness, and should ask: is it enough for the president of a country with the highest AIDS rate in the world to be ushered away from the responsibility of ensuring aid? And what damage is he doing from behind the scenes?

Matthew van Onselen

Power of Images in the fight against HIV/AIDS

November 9th, 2007


This blog focuses on a series of articles that appeared in the Sowetan last week: “HIV Man Grows Boobs” Condition a side-effect of ARV’s, Sowetan, October 31 st 2007 p1, "Man beats his breasts over ARV effects", Sowetan, October 31 st, 2007, p 5 and “HIV drugs can swell glands”, Sowetan, October 31 st, 2007, p 5.

Both the Treatment Action Campaign and Dr Francois Venter have issued statements in response to these articles. Both statements draw attention to the misleading, inaccurate information about anti-retroviral therapy the article contains and the dangerous consequences for the country’s treatment campaign.

What should also be noted are the powerful effects of images in shaping how people perceive and respond to the epidemic. The Sowetan chose to use an image of a man suffering from gynaecomastia on its front page. The man appears in the image without a shirt, his face partially obscured by a black box, presumably in order to protect his identity. Most prominent are his exposed breasts. This man, who is termed in the headline “HIV Man”, is reduced to his HIV positive status and what the paper depicts as the “freakish” side-effects of ARV drugs. The image and accompanying caption draws a connection between HIV and AIDS and abnormality.

The front-page photograph and screaming headline provide disproportionate coverage of a condition that only serves to compound fear and misunderstanding about ARV treatment. By granting this story disproportionate coverage, the Sowetan has given the impression to its readers that gynaecomastia is common among people who take ARVs and provides no information about how the condition can be treated. Surely some readers will look at the story and think: “If I take ARVs, I will grow breasts.” And this shouldn’t be unexpected as it is only towards the end of the article that the writer begins to suggest that this is not a common problem.

We asked Dr Glenda Gray at the Perinatal HIV Research Unit for her perspective on gynaecomastia resulting from ARV treatment. She said:

“Gynaecomestia is one of the most common body disorders in men irrespective of HIV status. Gynaecomestia is the medical condition and about 40-60 percent of males are affected by it. It has also been associated with ARV treatments like D4T, ddI and EFV. The person with gynaecomastia should discuss his treatment options with his health provider, in some cases it is reversible even on treatment, in some cases it is reversible when medication is switched, in some cases it may not be reversible. I suppose with ARV medication, there are risks and benefits, the benefits are survival, the risks are the side-effects one sees with long term therapy. With limited treatment options (first line containing D4T), we do expect to see metabolic side-effects, which need to be managed depending, if the side effect is severe, the medication should be switched, if it can be managed, then you want to preserve your first line. Sometimes when your choice is limited your choice is living with the manageable side effects, or dying from a life threatening disease. If I was in this person’s shoes, I would choose boobs!”

 

The Sowetan plans a series of articles on the side-effects of anti-retroviral drugs. Without changing the ways in which people living with HIV and AIDS are represented the side-effects of media coverage are far worse than anything that can be caused by ARV treatment. This kind of coverage perpetuates the fear and stigma around HIV/AIDS and further ostracizes people living with HIV.

How can the tabloid media improve its coverage of HIV/AIDS? Here are three simple suggestions:

Put the person before the disease. The Daily Sun and the Sowetan claim to be newspapers for the people, and yet frequently refer to people living with HIV as “HIV MAN” or “HIV GIRL”. One way to prove that you are actually papers for the people would be to stop dehumanizing people and instead put the person before the disease, as in “Mandla Ngcobo, who is HIV-positive.”

  • Ask readers to share their stories about living with HIV. You could call on your readers to share their stories about how they are living with HIV. If people could see a photo of and read about someone who was living healthily with HIV, it may alleviate some of the fear so many South Africans are living with, and might even encourage people to get tested.
  • Start a campaign to encourage people to get tested. Steal a page out of the Sunday Times by using your massive popularity to encourage people to take an HIV test. Considering the number of people who read the Daily Sun and The Sowetan, a campaign like this could play a role in reducing the number of new HIV infections in South Africa .

 

 

Brendan Kennedy and Kylie Thomas

 



Democratising Science

October 31st, 2007




If you missed our “Democratising Science” forum in September, you can read and listen to some post-forum interviews with several of the panelists at http://www.health-e.org.za/news/article_audio.php?uid=20031766, courtesy of the Health-e News Service. The text and audio is in both English and isiZulu.  

Shortcuts in the Aids war

October 31st, 2007

*Mike Seneka, Sabelo Zondo,
and Suzanne Leclerc-Madlala

From her 21 st floor office suite on Field Street, Princess Aisha estimates that she writes about a dozen prescriptions per day for fidelity protection medicine. As part of a large cornucopia of African solutions for the African HIV/AIDS crisis, substances that assist with HIV prevention have been largely overlooked in the wide media coverage of indigenous anti-AIDS treatments. Yet the booming market for muthis that help people to negotiate their way safely through an HIV-dense environment is well worth taking a look at. By examining what people are seeking in terms of support for HIV prevention, we might get a few good ideas about the type of HIV prevention messages that make sense to people and that speak to their desires.

Princess Aisha claims that the demand for fidelity protection medicines has skyrocketed in the past 3 to 4 years. “These days most of my customers look for love herbs. Its no longer married men leaving wives when they go to find work. Its now mostly single women who want their partners to stick to them. They are very worried about HIV.”

Unlike the ubejani-style tonics used to treat HIV/AIDS that are largely new mixtures developed to address the symptoms of this new disease, muthi mixtures used for HIV prevention purposes are mostly old ‘love-potion’ recipes that were once used sparingly and are now being used more frequently.

On a rainy Monday morning Princess Aisha’s small waiting room is filled with 11 twenty-something looking women and 3 older middle-aged men. Inside her ‘surgery’ there are two well-worn chairs, an old kudu skin rug, and a candle and mirror set on a small table. Aisha offers a 4-step treatment programme for securing the fidelity of a loved one. The initial consultation fee is R30 with a further R250 for the full course, which comes with a 3 year guarantee of partner faithfulness. The treatment does entail some risks however, and these are discussed before a client commits to the programme. Firstly, a client must be sure that he or she wants a particular partner for the entire 3 year period. Otherwise, should the client change his or her mind, the ‘treated’ partner will become obsessed and will stalk the client for a long time afterwards, possibly for the rest of their life. Secondly, if the client fails to renew the treatment at the end of the 3 years, then a difficult break-up can be expected, with the ‘treated’ partner becoming violent before leaving abruptly. According to Aisha, most of her clients are prepared to take these risks.

The programme starts with the client sprinkling a small amount of a powdery substance onto his or her private parts and around the marital or partnership bed before making love. For the treatments to be effective they must be done in secret with the partner never suspecting anything. Step two involves putting some of your bath water aside and using it from time to time to add to your partner’s food or drink. Step three is sprinkling another powder into your partner’s favorite drink. Step four, which consolidates fidelity, involves bringing the herbalist a piece of your partner’s clothing that is later returned along with instructions to bury it in your garden while repeating an incantation along the lines of ‘you are mine forever and only mine forever’.

For under three hundred rands this fidelity protection programme is relatively cheap when compared to what other herbalists in the Durban city centre are asking for a similar prescription. A certain Prophet Manna sells a set of 7 colourful strings to tie around the waist at R50 per string, or R3500 for the complete set. But the promise of ‘full spectrum’ treatment that works on multiple levels to create the kind of relationship that could protect both you and your partner against HIV is evidently worth the price. Not only are these mutis said to make your loved-one ‘blind’ to other potential rivals, but they also increase your own as well as your partner’s interest in sex, responsiveness to sex, and your desire to touch, kiss and fondle, according to Princess Aisha. In the unlikely event that a rival should take advantage of your partner against his or her will, that rival can expect to feel immediately fearful, sick or possibly even die, depending on the type and strength of the protection muthi used.

Princess Aisha thinks that while the high price of lobola is a factor behind the demand by men for fidelity protection medicines, fear of contracting HIV/AIDS is the primary reason for their current popularity. By offering a culturally familiar way to fulfill a desire for love, devotion and the type of fidelity needed to help guard against exposure to HIV, the bustling trade in these protective medicines makes perfect sense. For one thing they provide a countervailing force against the social pressures for and expectations of multiple partnering. Covert use of these substances may help to give some people confidence in their ability to control and maintain a monogamous relationship. A growing demand for fidelity protection medicine probably reflects a growing eagerness for faithful and stable relationships.

In this time of HIV/AIDS there is a real need to get people talking about things like love, sex, desire and expectations in relationships including marriage. Using fidelity protection medicines is a convenient way to avoid the difficult task of verbal communication and negotiation for safe sex. Muthi peddlers like Princess Aisha who sell the illusion of HIV protection to desperate and vulnerable people are little more than criminals. The only real solution to the social disease of HIV/AIDS is a conscious effort to change behaviour and norms. Medicines, whether they are African, western, traditional, modern, or otherwise will never percolate into the roots of this disease.

* The authors are the recipients of the HIV/AIDS and the Media Fellowship of the Perinatal HIV Research Unit and the Journalism Programme at Wits University

“It’s not about how many condoms have gone out, but about how many have been recalled”

October 23rd, 2007

The above quote is taken from Health Minister Manto Tshabalala-Msimang’s response to media reports that more SABS-approved condoms have been recalled due to concerns about defects. Clearly she is confused as to where the problem lies, for if she fully appreciated the dangers of roughly 8 million defective condoms in possession across the country, she would not so proudly boast the successful recalling of 12 million others (as reported in “Dud condoms plague SA’s AIDS campaign: http://www.businessday.co.za/articles/topstories.aspx?ID=BD4A593498)

The role of the media in these situations (which are all too common in the fight against AIDS) is an important one. On the one hand, the government might point to the public condemnation of these errors as contributing to the undermining of the AIDS campaign, resulting in reduced faith in the government’s ability to tackle the AIDS pandemic. This would prove highly detrimental in a country where condom use is primary tool against AIDS, and where convincing people of the importance of condoms is such an onerous task.

On the other hand, there are democratic concerns about realistically depicting what the government is and is not doing. In this way the media can hold the government accountable for its actions, flaws in the administration of campaigns can be identified, and mistakes can be scrutinized and evaluated, resulting in considered debate about what next can be done to more successfully deal with the situation at hand.

By Matthew van Onselen

The following is taken from the TAC electronic newsletter, 23 October 2007:

The Department of Health has asked for the statement below, on recalled condoms, to be distributed widely. It is critical to restore confidence in government’s condom distribution programme and therefore the Treatment Action Campaign encourages the distribution of this statement. We welcome the Department’s commitment to resolving this issue. We ask the Department and the South African Bureau of Standards to follow this up by indicating precisely what measures they have taken to reduce the likelihood of faulty condoms passing quality control again.

Please note that if you have condoms with the manufacturer’s code 6809/MED/ on them, they should be returned to the Department of Health. The address is:
Department of Health - HIV Unit,
226 Vermeulen Street ,
Hallmark Building ,
Pretoria 0001

The following condoms should be returned:

Those with the manufacturer’s code 6809/MED/ (it is not clear what the brand name of these are but we [i.e. TAC] think it is Choice)

Ultramour

LSP

Makoya

Randy Rat

Condom Concept

Positions

African skins

Choice – Lot number 4308/ZLX/

Media Statement by the Minister of Health on the Condom Distribution Programme

22 October 2007

Last month, the Department of Health stated that according to the internal audit at the South African Bureau of Standards (SABS) there were anomalies requiring a further investigation of more batches of condoms supplied by at least three of the seven companies responsible for the tender. These companies were Kohrs Medical, Juel Health and Sekunjalo.

The audit followed the charges that Zalatex (which distributed condoms produced by Latex Surgical Products) bribed an official of the SABS to approve condoms that were not conforming to the quality standards. The Department acted swiftly in removing from circulation condoms supplied by Zalatex that were suspected of not meeting the quality standard. More than 5 million condoms were recalled and another 7 million quarantined at the company’s warehouse.

The SABS recommended at the time that the Department quarantines the most recent batches of condoms supplied by these companies for retesting. This was intended to verify the quality of these condoms and inform the final conclusions of the audit process that was underway.

The SABS has reported to the Department that this verification process has been completed and the findings were as follows:

1.At least 5 batches belonging to Kohrs were sampled and they failed an airburst test. The SABS has reported to the Department of Health that based on the results, SABS was suspending Kohrs use of the SABS mark/certificate until remedial action is taken by the company to rectify the quality issues.
2.Samples tested relating to Juel Health and Sekunjalo were found to be of adequate quality.

Based on the conclusions of this audit process, the Department is recalling the products supplied by Kohrs. We appeal to the public and all partners involved in the distribution and promotion of the use of condoms to assist with the recall of these condoms. The condoms produced by Kohrs are identifiable with the manufacturer’s code 6809/MED/.

SABS has reported that, currently, there is no information suggesting collusion between Kohrs and the official of the SABS who is charged of corruption. However, the Department of Health notes that a large stock of condoms that was dumped at Inanda, in KwaZulu-Natal were produced by Kohrs. This matter is under police investigation.

During this financial year, Kohrs has supplied 5 million condoms to the Department. Of this, more than 1 million condoms have been quarantined at the distribution sites as part of the audit process. In the same way as we acted against Zalatex, the Department will no longer be procuring any stock from Kohrs.

The quantities that would have been supplied by Zalatex and Kohrs - which is 09 and 15 percent respectively of the projected 425 million male condoms supplied per annum - will be shared equitable amongst the other five companies over the remaining period of the contract ending in February 2008. SABS is satisfied with the quality of the condoms supplied by these five companies.

The SABS has indicated that extensive controls and verifications have been implemented throughout the testing and certification process to ensure that all condoms supplied under the SABS mark and under the Choice brand, comply with standards set by the World Health Organisation.

Condoms are a crucial element of the Department of Health’s programme to prevent sexually transmitted infections including HIV and unwanted pregnancies. The two incidents involving Zalatex and Kohrs should not be allowed to impact negatively on the significant progress we have made in promoting condom use in the country.

Through the Khomanani Campaign, the Department of Health will be making efforts to emphasise the messages that correct and consistent use of condoms is important in preventing sexually transmitted infections. We hope that other partners involved in the response to HIV, STIs and unwanted pregnancies can assist us in reinforcing the message that condoms are important in protecting our health.

Dr Manto Tshabalala-Msimang
Minister of Health

Contact
Sibani Mngadi
0827720161

Weekend round-up

October 23rd, 2007

With the Boks’ big World Cup semifinal game and the ongoing Mbeki-Selebi-Pikoli saga grabbing most of the big headlines this weekend, there wasn’t too much on the HIV/AIDS front, but here are a handful of stories from the country’s major weekend reads.

"Mob stones to death man accused of killing HIV-positive son and girlfriend"
City Press - 14 October 2007
This short article of only a few hundred words is troubling on many fronts, but it highlights the important point that HIV stigma is still prevalent, and that disclosing one’s positive status can have violent repercussions. The article concludes with an interesting quotation from the Mpumalanga provincial coordinator for the Treatment Action Campaign; he says: "I blame the people who gave the woman the ARVs, because it seems they didn’t give her the proper support as to how to disclose the information to her partner or family." Granted, the now-deceased woman in question may not have been counseled on how to appropriately disclose her status to her family, but the burden of this task and its unfortunate outcome should not be placed entirely on her. The larger community itself must also play a role to de-stigmatize this disease in the public consciousness. While one would never condone vigilante justice, perhaps that’s exactly what certain members — those engaged in the stoning of the man — of this community were trying to do when they committed this violent act.

"HIV vaccine ‘not just a scientific challenge’ "
The Star - 12 October 2007
In this short article, which announces that Dr. Alan Bernstein has been appointed as the first executive director of the Global HIV Vaccine Enterprise, little of substance is actually said about HIV vaccines. "We need some new ideas," Bernstein said, but he does not elaborate any further. It is noteworthy that this announcement took place in Cape Town , South Africa , because of the high prevalence rates here, which Bernstein acknowledged makes SA "unfortunately" a good host country for vaccine trials.

" ‘What’s sex work, Mommy?’ " and "Lessons in prostitution slated"
Weekend Argus and Saturday Star - 13 October 2007
This story, which appeared in both the Saturday Star and the Weekend Argus (and likely several other of Independent Newspapers’ Saturday papers), describes the outrage of parents, researchers and child psychologists over the content of a Grade 5 textbook entitled "My Clever Natural Sciences Through Issues." Nobody at the HIV/AIDS and the Media Project has seen the textbook, so it’s difficult for any of us to comment on it directly, but it seems, from the comments made in the article, that the criticism of the text is wholly justified. As the article relates, the text provides a grossly oversimplified, inaccurate, paranoid, fearsome and generally age-inappropriate story about a sex worker who contracts HIV. So, we know for sure how not to teach children about HIV/AIDS, but then how should we be teaching them? Hopefully this embarrassing gaffe on the part of the ministry of education will open up a meaningful debate about HIV/AIDS education at the primary school level, and hopefully HIV/AIDS activists and educators can work together to come up with a worthwhile educational project on this issue.

"Kilimanjaro: a new beginning"
Sunday Times - 14 October 2007
In this week’s "Everyone Knows Someone" feature of the Sunday Times’ News and Opinion section, Claire Keeton tells the story of Phindile Madonsela, who was raped at the age of 16, discovered her HIV-positive status 10 years later while trying to give blood, and this year, at the age of 36, climbed to the top of Mount Kilimanjaro in Tanzania. But the most interesting parts of her story happen well before the triumphant climb - when she publicly disclosed her HIV status in 1997. Her story is a typical one in which she faces stigma and ignorance from friends, family and her community. But she persevered through it, became an activist along the way and set out to educate as many people as she could.

"At last I’ve broached the taboo subject"
Sunday Times - 14 October 2007
The second story in the Sunday Times’ "Everyone Knows Someone" feature is a simple, but valuable story about an average person - in this case, author Simphiwe Piliso - and his day-to-day encounters with the topic of HIV/AIDS. Piliso makes the important point that even if you yourself are not infected, and even if none of your immediate friends or family are, you can still play an active role in fighting the virus by talking about it with other people.

By Brendan Kennedy

Separation Anxiety

October 23rd, 2007

"Factory gives jobs and hope to HIV people"
Sunday Times - 14 October 2007 - p. 14

This article tells the story of a toy-manufacturing company in Bronkhorstspruit, Gauteng, called The Cuddle Company, which only hires people who are HIV-positive or are otherwise affected by the disease (young people who have been orphaned by HIV/AIDS, for instance). The Cuddle Company is a commercial initiative of the Dutch non-governmental organization KidsRights, and in addition to providing jobs for people affected by HIV, the initiative also donates a portion of its profits to the St. Joseph’s Care and Support Trust at Sizanani Village, which provides antiretroviral drugs and operates a feeding scheme to those affected by HIV in the community. The toys manufactured at The Cuddle Company are made for export to Holland .

On one hand this seems like a simple feel-good story about a company that is concerned about something other than its bottom line, and not only that, it is also contributing positively to the community. But on the other hand, this story raises several problematic questions. Firstly, should we be content, as a society, to simply shun people living with HIV in the regular workplace and instead construct these "protected" workshops where they will only be interacting with other HIV-affected people? What are the societal root causes that are driving the creation of this initiative in the first place? Could this initiative actually be counterproductive by not only taking the government and employers off the hook, but also giving the public the idea that these kinds of HIV-only work environments are a preferred socio-economic solution to the "problem" of employing people with HIV.

Take this comment, for example:
"Angela Maake, health services manager for St. Joseph ’s, said: ‘For many here, it’s like heaven because where else would they find jobs? They can now lead normal lives."

Where else would they find jobs? Well, they have the human and constitutional right to find employment wherever they are qualified, regardless of their HIV status. And where this is not true, Maake and company should be looking at the root causes of why it is not true, rather than creating a parallel workspace (and parallel universe, essentially) where only HIV-positive people will interact with each other.

And here: "… Mkhwanazi believes that one of the biggest benefits is that HIV-positive workers can freely discuss their health issues with colleagues and management without fear of victimisation." As nice as it is that Mkhwanazi and his co-workers feel safe and supported at The Cuddle Company, HIV-positive employees anywhere should be able to freely discuss health issues with colleagues and management without fear of victimisation. In places where they can’t do this, we should be asking "How can we fix that?" rather than trying to avoid it.

All this said, The Cuddle Company does certainly seem to be a conscientious and generous employer: "The company also provides its 9 male and 36 female workers with lunch and free healthcare. “Workers on ARVs are also given time off during the month to collect their medication. This is perhaps the only company that allows its staff to do this during working hours." But again, this raises the issue of specializing this kind of treatment of workers and HIV-positive people instead of normalizing it and expecting it from all employers.

While initiatives such as this one run by KidsRights can be positive experiences for the individuals involved in them, we have to look at their larger impact on society as a whole, and the media needs to continue critically assessing the causes and effects of initiatives like this one.

But, above all, we have to realize that it is not good enough to simply tolerate people living with HIV in our communities. We have to be willing to interact and engage with them as regular human beings, with equal civil, political and social rights. Before we applaud initiatives such as this one for creating a supportive and healthy work environment for people living with HIV, we should be asking ourselves why we don’t simply expect it from all employers.

By Brendan Kennedy

HIV/AIDS and the Media Project discussion forum

September 18th, 2007



On Thursday, 27 September, the HIV/AIDS and the Media Project will host a discussion forum on science reporting and HIV-prevention trials entitled “Democratising Science”. The forum aims to open discussion on science reporting and clinical trials, with a particular focus on the global campaign for microbicides. Participants in the forum include researchers currently investigating microbicide trials, health journalists, HIV/AIDS activists and academics. Hopefully you will be able to join us for what will surely be an important and lively debate. 

 

Democratising Science:

An HIV/AIDS and the Media Project discussion forum

 

Khatija Ahmed (Principal Investigator, Phase 3 trial of Carraguard)

Belinda Beresford (Health Journalist)

Jillian Gardner (Steve Biko Centre for Bioethics)

Glenda Gray (Perinatal HIV Research Unit)

Suzanne Leclerc-Madlala (Director of Anthropology Program,UKZN)

Luckyboy Mkhondwane (Treatment Action Campaign)

Mary-Jane Malebo Ratlhagana (Microbicides Trial Community Outreach)

and Helen Rees (Reproductive Health and HIV Research Unit)

 

Date: Thursday, 27 September

Time: 4:00 – 6:00 p.m.

Venue: Origins Centre, University of the Witwatersrand

 

The forum will also be audio-streamed live at http://www.journalism.co.za.

 


Journalists need to be critical of HIV-prevention efforts

September 17th, 2007



In this week’s Sunday Independent, page three of the “Dispatches” section (page 15 of the newspaper), was dedicated entirely to a package of four articles from the Health-e News Service syndicate, which looked at the crisis of HIV/AIDS and poverty in the Letaba district of the Limpopo province. With varying degrees of overlap, the stories addressed the troubling issues of how the pandemic is creating an overwhelming number of orphans, which in turn leads to the problem of child-headed households; the lack of funding and capacity for most villages to provide basic services, such as health and education, to the growing number of orphaned young people; and the strain on home-based caregivers and other volunteers. The articles also all focused, in one way or another, on the role and response of the Catholic Church in Letaba.

What was glaringly absent from the collection of articles—especially when those interviewed spoke of the alarmingly high rates of new infections among young people, and how people dying of AIDS-related diseases were becoming increasingly younger—was any mention of the Church’s refusal to promote condoms as an effective means of prevention against HIV.

In fact, the word “condom” did not appear anywhere in any of the four articles.

“ ‘We can definitely see that the people who are dying are younger. We bury very few old people. Most of the deceased are between nine months and 45 years old,’ said Hartzenberg.

“Mauritz de Bruin, who has been running the mortuary for the past 11 years, concurs: ‘In the past we had mostly old people. Now it’s mostly young people in there,’ he says, motioning to the four white fridge doors behind him.”

In spite of the fact that it is young people who are dying in this district and the highest HIV-prevalence rates are among young people in South Africa, the author does not raise the question of possible problems with the Church’s approach to prevention.

The article’s author vaguely addresses the issue of the church’s prevention methods here:

“ ‘I said to myself that it’s got to hit South Africa, too, and we tried to run awareness programmes, but people laughed at us. We got nowhere. Nobody was interested at the time,’ recalls Slattery, who is adamant that the solution lies in promoting changes in behaviour and giving people hope.

“ ‘The solution ultimately lies in building family life and a sense of respect. We need to see Aids in the context of making us a stronger nation. Maybe we need to say that what doesn’t kill us will make us stronger,’ he says.”

So despite the rising rates of infection among young people in his district, Slattery is still “adamant” that prevention efforts should be focused on promoting changes in behaviour. The article’s author should have asked Slattery if his mind would change if infection rates continued to climb and young people continued to die at such an alarming rate.

Without taking anything away from all of the great work the Catholic Church does in Letaba and similar areas across the country, especially in terms of treatment and providing access to ARVs, it’s still a little mind-boggling how their potentially harmful approach to prevention is never raised in any of the articles.

I suppose that since the articles deal with the Catholic Church, its position on condoms or non-abstinence-based prevention programs in general can be, to a certain extent, taken for granted. But there are exceptions: some Catholic priests have promoted condom use in the context of the epidemic. Regardless, the questions should be asked.

Do the young people in Letaba ever ask about condoms? If they do, how do the archdiocese, the volunteers and the ground-level service providers respond to those questions?

Do all of the service providers believe in the Church’s approach to prevention? Do any of them feel constrained to abide by Church doctrine even if it contradicts their own ideology or intellect? How do they cope with that? Do the service providers simply believe that since there are so many infected people who need treatment and support, and the Church is in a position to provide that support, they will work with the Church despite their ideological conflict?

Has anyone in the archdiocese ever suggested that condoms could help lower HIV-incidence rates among young people? Have they talked about it, even informally?

It would’ve been nice to see at least some of those questions asked.

While the Church’s work in Letaba is clearly substantial, and they are obviously engaged in significant and worthwhile support for people living with HIV and Aids, their prevention efforts should be challenged. It isn’t enough that civil society organizations, such as the Tzaneen archdiocese, respond to the crisis of the epidemic, but that they respond in ways that actually make a difference.

Although it’s important to highlight the efforts of any group fighting HIV/AIDS and supporting people living with the disease, journalists must still be critical of their approach.

Brendan Kennedy

Articles discussed in this blog:

“Death has become ‘normal’ in Limpopo” Sunday Independent, 9 September 2007, p. 15, Health-e News Service

http://www.sundayindependent.co.za/index.php?fArticleId=4025025

“There’s fun and laughter at a centre toddlers call home” Sunday Independent, 9 September 2007, p. 15, Health-e News Service

(subscribers only)

“Care for those with nothing” Sunday Independent, 9 September 2007, p. 15, Health-e News Service

(subscribers only)

“Rural schools shoulder Aids-orphan burden as farm jobs dwindle” Sunday Independent, 9 September 2007, p.15, Health-e News Service

(subscribers only)



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