Swaziland's Huge AIDS Problem
Daily Mail & Guardian

Swaziland is a small country geographically, and its population numbers less than a million. But it has an oversized Aids problem.
"We have a disproportionate Aids dilemma. It comes from a failure in the past to own up to an emerging crisis," said an official with the Ministry of Health.
As the international community marks World Aids Day on Monday December 1, Swaziland has reached an unhappy milestone. The country now has the same proportion of adults infected with HIV as Botswana, the country with the greatest HIV prevalence rate.
HIV is the virus that attacks the immune system of people, causing them to succumb to Aids-related illnesses.
A report released just before World Aids Day by the United Nations Children's Fund (Unicef) described the Aids pandemic in Swaziland succinctly.
"The epidemic has assumed devastating proportions," said the document, adding that "National HIV prevalence in Swaziland has matched that found in Botswana, almost 39%. Just a decade earlier, it stood at 4%."
Worse still, the infection rate shows no sign of slowing down any time soon.
"We are doing too little, too late," said Hannie Dlamini, president of the Swaziland Aids Support Organisation, which counsels HIV-positive persons.
Health workers cannot help comparing Swaziland's situation with that of Uganda, where political leaders recognised the danger posed by Aids early in the pandemic's existence, and began prevention and mitigation programmes to halt its spread. Their efforts succeeded, and Uganda's HIV prevalence rate is today a relatively low 7%.
In contrast, it is still taboo for most Swazis to admit they are HIV-positive. A front page story this week in the Times of Swaziland described the discrimination suffered by an HIV-positive man at his workplace. His boss refused to sit next to him for fear of contracting the disease -- suggesting widespread ignorance of how Aids is spread.
In the midst of this fear and misinformation, churches are stepping forward in the fight against HIV.
"A heavy mantle of shame cloaks Aids in Swaziland. It is the duty of churches to bring moral guidance to the issue. Aids isn't about sin, it's about a virus," Reverend Jabulani Dlamini of rural Mliba said.
Other positive developments include efforts to ease the effects of the pandemic in rural areas, using money from the Global Fund to Fight Aids, Tuberculosis and Malaria. These efforts are taking place under the auspices of the national emergency response committee on HIV/Aids (Nercha).
The Alliance of Mayors Initiative to Combat Aids at the Local Level (Amicaall) has focused on how Aids is ravaging urban areas.
This year has also marked the introduction of anti-retroviral drugs in Swaziland. The process has been slow, but there are plans to expand distribution, while nurses and caregivers are being trained in administering the medicines.
However, certain health workers fear that new programmes for treating Aids patients may distract public attention from an equally important goal: HIV prevention.
"This is the opposite of what we did before, just a few years ago, when we tried by all means to stop people from getting infected. We failed," says a nurse in the central town of Manzini, who asked not to be identified.
"Now, we seem to be concerned mostly with people who are infected, and extending their lives. That is important, but what about stopping Swazis from getting infected in the first place?" she asked.
Unicef appears to be aware of this danger. The UN agency has partnered with church groups in a major undertaking to raise awareness of the extent to which children are sexually abused in the kingdom.
"Incest has been shown to be a major cause of HIV in children," said Unicef Swaziland's national representative, Alan Brody.
Nercha is distributing Global Fund grants to rural communities to handle a growing population of orphans whose parents have died of Aids, and is also financing the refurbishment of clinics.
Established last year, the committee accepts proposals from organisations to combat Aids, and approves those that are likely to benefit the greatest number of people.
Amicaall functions in a similar fashion. Community coordinators attached to Swaziland's 11 most populous towns advise individuals and organisations on how to submit applications for grant money. When these are approved by Amicaall and local governments, technical support is given to build an orphanage, run an education campaign, or provide a network of home care for Aids patients.
Rudolph Maziya, Amicaall's national director, is at pains to point out that there is cause for hope in Swaziland on World Aids Day 2003, despite the rocketing HIV prevalence rate.
"Things have taken off in 2003, and we have positive accomplishments to report for Worlds Aids Day. Much more, obviously, has to be done before the HIV infection rate slows, and is reversed," he said. -- IPS




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