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AFRICA
Aids and a lost generation: children
raising children
Ruth Nakabonge crouches on the ground clutching a
handful of earth to fling over her father's coffin. She is too
distressed to cry, her tiny body contorted by grief as a relative gently
strokes her forehead. Ruth was eight when her father Samuel died of Aids
in their Ugandan village. She has not just lost a father, she has also
been deprived of a childhood, like millions of other children across the
continent. Samuel Nakabonge is not just another Aids statistic. He is a
symbol of how the Aids pandemic is still cutting down the breadwinners
of Africa in their prime, leaving behind an army of orphans. Girls like
his daughter Ruth suddenly find themselves thrust into the role of
parent, responsible for the welfare of their siblings. Samuel lost 10
members of his family to Aids before he succumbed to an opportunistic
disease that took his own life, his body wasted from the virus that was
once known as "the slims" in his country.
It is easy to see how Aids is responsible for creating
a missing generation across Africa, devastating economies, and crippling
health sectors as it strikes. Across the continent, 6,500 Africans are
dying every day, the equivalent of a village being wiped from the map
every 24 hours. A further 9,000 are infected each day by HIV/Aids, which
is the leading cause of death in Africa.
In Uganda, 84 per cent of Aids victims contract the
disease through heterosexual contacts. The men go first, followed by
their wives. Fourteen per cent of children are infected by
mother-to-child transmission. Up to 6.6 per cent of the adult population
in Uganda is infected with HIV. If you are an adult male in Uganda
suffering from Aids, you are unlikely to live beyond the age of 47. In
Zimbabwe, the population is already struggling to survive an economic
crisis and an inflation of 1,000 per cent, brought about by the policies
of their tyrannical leader President Robert Mugabe. Now, one in three
children in Zimbabwe are Aids orphans, and the anti-retroviral drugs are
running out.
In the continent's economic powerhouse, South Africa,
800-900 people every day are dying from Aids. The country holds the
dubious record of having 5 million HIV/Aids sufferers: the highest
number in the world, with 21.5 per cent of the population infected.
"President Thabo Mbeki and Health Minister Manto Tshabalala-Msimang have
failed to provide unambiguous and clear leadership on Aids," says Mark
Haywood of the Treatment Action Campaign, which successfully sued the
South African government to roll out anti-retrovirals. "South Africa is
getting it wrong at the very top." "They [the leaders] still send out
confusing signals doubting the efficacy of ARVs. Some people are now
actually scared of treatment. It's a tragedy," Mr Haywood added.
Africa still lags lethally behind the West, which has
taken great strides thanks to life-saving anti-retroviral drugs. Falling
drugs prices and new sources of international funding are needed to help
it catch up. Aids treatment varies from country to country, but also can
vary greatly from place to place within a single state, and even within
a single city.
Botswana's biggest hospital, the Princess Marina in
Gaborone, recorded eight people yesterday who died of HIV-related
illnesses. Yet at the Botswana-Baylor Children's Clinical Centre of
Excellence, which benefits from Western cooperation in a public-private
sector partnership, the chief nurse, Liz Lowenthal, said that no deaths
were recorded at her Gaborone clinic in the past 24 hours. "We have
about 1,400 children receiving highly active anti-retroviral therapy (HAART)
through our site. Walking through the waiting room, you would not
recognise most of these children as being ill in any way," she says.
"The areas where death rates are high due to Aids-related illnesses are
those in which HAART is not readily available. In Botswana, when
children are diagnosed early, they are entitled to free treatment and
generally do as well as children in Western nations on the same
excellent regimens," she said.
So even in Africa the picture is not entirely gloomy.
Governments - including those of Uganda and Botswana that have put Aids
at the heart of government policy - have notched up some successes. But
it is not just a lack of appropriate medicine that is preventing Africa
from saving a generation. Other major obstacles are preventing the Aids
pandemic from being conquered. One of these is ignorance of how the
virus spreads.
In South Africa, whose urban blacks have had the
benefit of education, a former deputy president of the country, on trial
for allegedly raping a 31-year old HIV-positive woman revealed the depth
of ignorance about how HIV/Aids is transmitted. Jacob Zuma told the
court that he was safe from contracting the disease because he had taken
a shower after having unprotected sex with the woman, an Aids activist
and family friend. He said that it was his understanding that it was
difficult for a man to contract HIV by having sex with a woman. Mr Zuma
was acquitted of the rape charges last week. Aids campaigners complained
that his statement in court had thrown years of hard work in Aids
awareness down the drain.
A second obstacle holding up progress is the issue of
abstinence, with programmes in Africa promoted by the Christian right
wing in America and advocated by such prominent politicians as Colin
Powell, the former secretary of state. Ugandans were once told that "the
slims" could be kept at bay through the ABC strategy of "Abstain, Be
faithful and wear Condoms" . But now, thanks to US-funded programmes
which carry ideological conditions, the condoms are literally being
thrown away, and HIV-Aids infections are on the rise again.
Ruth Nakabonge's father died five months ago. Since
that time, according UN estimates, 31,950 Ugandans have perished from
HIV/Aids - and almost one million Africans have died. How many more
villages will fall silent before the global response catches up with the
deadly pace of the pandemic?
A continent's misery
- Sub-saharan Africa is home to 10 per cent of the
world's population and 60 per cent of the world's Aids population.
- Right now in Nigeria, there are 1.8 million Aids
orphans. There are 12 million across the continent.
- In South Africa, 4,000 teachers will die of Aids
this year.
- 37.5 per cent of South Africans would keep it
secret if a family member was diagnosed with HIV.
- 66 per cent of South Africans think they will never
contract HIV. 41 per cent of those use condoms.
- 6,500 people died from Aids on this day last year
- There is at least one HIV-positive child in every
classroom in Botswana
- 9,000 people across Africa are infected daily
- More than 15 million people in Africa have died of
Aids, more than the highest estimates of the Rwandan genocide
(800,000), Khmer rouge regime (up to 2 million), Holocaust (11
million) and Iraq war (up to 38,000) combined.
- Only 16 per cent of HIV positive people in Africa
can hope to receive antiretroviral drugs.
Anne Penketh
16 May 2006
http://news.independent.co.uk/world/africa/article484993.ece
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