Wednesday, December 10, 2008

Guess Who's Pregnant!

NOT ME. But didn’t you think for just a second that it was me? Okay, not funny. But add this to the list of Things I’ve learned in Swaziland: dog’s don’t have menopause. At least Swazi dogs don’t because Bokhi, who is approximately 9 years old, is pregnant. That’s like a 60-year-old woman getting pregnant. (Which I guess is not that outrageous since this week a 70-year-old woman in India gave birth.) Also, several times I have seen Gogos (grandmothers) breastfeeding babies that are obviously not theirs (great way to spread HIV, ladies) and according to the Baylor doctors it’s a fairly common practice when a baby’s mother dies or abandons the baby. How does that work? Is Swaziland just a magical land of fertility? Somebody please tell me.

Anyway, the anticipation of new furry friends is pretty much the highlight of my life. A volunteer came to visit this weekend, which was nice and gave me an excuse to make some delicious apple crisp. (It wasn’t really crispy, but I think that’s because he got impatient and made me turn up the temperature so it just burned instead of crisping. Not my fault.) and two other volunteers are coming to visit in the next week to distract me from boredom (and to “do work,” but mostly to distract me). I put up my mosquito net, which I already hate because it disrupts air circulation, but if it keeps me from being awakened by flies crawling on my face in the morning I will keep it up. Work-wise, this week I visited the NCP (neighborhood care point) to play with children (they found a 2 meter long snake outside the NCP shortly before I arrived so all our playing was done inside), attended a meeting conducted entirely in siSwati that I think had something to do with cows and counted thousands of pills (Cotrimoxizole) at the clinic until I was nauseous and covered in a thin white powder. We also have a Youth Conference in Nhlangano, which is essentially a party for youth active in HIV/AIDS-related activities in their communities, but the extent of my participation in that event is that I’m showing up on time and bringing the Rihanna CD for entertainment (thanks Ben!).

Yeah, since school is out I have nothing to do with myself. I guess now I’m finally experiencing the level of boredom that all the other, non-teaching volunteers have been dealing with for the last 6 months. Who knew? But I fill my days with reading, cleaning, talking to the dog and laying on my floor in a swimsuit in an attempt to tan my legs before we go to Mozambique for Christmas. Seriously, I have nothing to do.

In my boredom, I did happen to stumble upon (in a stack of papers in my room) a 2007 report about the status of HIV/AIDS and related efforts in Swaziland. It’s titled “Reviewing ‘Emergencies’ for Swaziland: Shifting the Paradigm in a New Era” and it’s probably available on Google Scholar if you’re interested (by Whiteside, Whalley and Naysmith). The whole thing essentially provides the grim statistics to support the really depressing fact that the HIV/AIDS epidemic in Swaziland has become a normal part of life and therefore isn’t being treated like an “emergency.” When you see the abnormal as normal, you don’t see the problem. Welcome to Swaziland. Here are some facts for you:
· 7,671 people in the world die of AIDS-related infections each DAY and there are currently 38.6 million people worldwide living with HIV; 225,600 of them live in Swaziland
· In Swaziland, HIV prevalence in antenatal clinics increased from 3.9% in 1992 to 42.6% in 2004 (est.), which is the highest prevalence in the world (and it’s increasing)
· Life expectancy in Swaziland has decreased from 60 years (1997) to 31.3 years (2004), and the crude death rate has doubled since the early 1990s
· 47% of children who die under the age of 5 die of HIV/AIDS; 10% die of diarrhea, which is entirely preventable and curable; 12% die of pneumonia
· Shiselweni Region (where I live) has a daily mortality of approximately 1.8/10,000; anything over .85/10,000 is considered an “emergency” by the WHO
· There are 130,000 OVCs (Orphans or Vulnerable Children, includes single and double orphans and those living in households with HIV-positive parents) in Swaziland and 48% of all households are hosting children orphaned by HIV/AIDS (mine hosts 7)
· In 2007, over 400,000 people in Swaziland required emergency food aid (that’s 40% of the population) due to drought or AIDS-related interruptions in agricultural production
· In 2007, 35% of Swazi families reported that they sometimes had to skip meals for an entire day to cope with food shortages; 58% of families reported reducing the number of meals consumed daily and even more said they have reduced portion sizes
· Due to drought and decreased agricultural production, the cattle population of Swaziland has fallen 11% in the last decade with the herds of AIDS-affected families decreasing by 30% (they often have to sell cows to pay for other things like transport to hospital)
· There are approximately 440,000 goats in Swaziland, 15 of which live on my homestead
· There are only 160 licensed doctors in Swaziland (population 1.2 million) and 49% of them work in private practices, making them inaccessible to the majority of the population. Why? Swaziland lacks the technical capacity to train doctors, so 100% of doctors are trained abroad and most never return to Swaziland. (Do you blame them?)

The paper essentially concludes that in Swaziland the HIV/AIDS epidemic has become “normal” and is being accepted as such both within the country and from international agencies, which are primarily designed to respond to short-term emergencies (ie, tsunamis, SARS). It argues that a new international strategy needs to be created to address problems like the HIV/AIDS epidemic in Swaziland, where the virus has effectively reversed all developmental progress made in the past few decades. The economy is collapsing, the age structure is being altered, hundreds of thousands of children are orphaned (and most are now being taken care of by grandparents, who won’t live forever), the workforce has been gutted, the drought is literally starving the country…The UN says it’s a “triple threat” of “a lethal epidemic, deepening food insecurity and a hollowing out of government capacity.” So what do you do?

In reality, there is nothing “normal” about it at all, but the government and other sectors working to fight HIV/AIDS have become overwhelmed with just relieving the symptoms of the epidemic (providing care for people with HIV to prolong their lives so they don’t orphan their children, supporting the orphaned children, providing enough maize meal to fill their bellies) and other short-term goals that they’re just hoping it will get better in the future. There are no concerted efforts aimed at relieving the underlying causes of the epidemic (cultural customs that give girls no choice in sexual relations, economic conditions that force some into prostitution, lack of support from prominent people in the country to get tested for HIV, stigma, the fact that concurrent multiple sexual partners are not only accepted but expected of young men, the high birth rate). And, in fact, I’m part of that effort at alleviating the symptomatic impact of HIV/AIDS (support group, providing food at the NCP, refilling ARVs at the clinic) because where do you even begin to change the big stuff? And do you really let a little boy starve because you want to use the money previously spent on his CSB (Corn-Soya Blend, the most commonly distributed food by the WFP) on some long-term plan to change sexual behavior? But eventually the WFP will stop giving out CSB. Then what? When do we start worrying about that?

On that depressing note, if you’re looking for a good way to spend your money this month (or ever), check out . Young Heroes is an organization started by former Peace Corps Volunteers in Swaziland that provides HIV/AIDS orphans and child-headed households with food, clothing and sponsorship for school fees. Sponsoring a family costs as little as $19.95 per month and I can promise that the money actually goes where they say it does. (And if you decide to sign up, you should comment that you’d like to sponsor a family in Shisizwe/HhoHho Emuva because that’s my community and we’re trying to get them involved here.) And if you’re doing last-minute Christmas shopping, check out Swazi Market (you’ll have to Google that because I lost their business card). They teach various skills (basket-weaving, soap-making, wood carving, fabric dying, jewelry-making, etc.) to widows and others affected by HIV/AIDS and then sell the crafts at international craft fairs and things. And they have some amazingly beautiful things, too.

Or if you want to contribute to the Justine’s Mozambique Vacation Fund, you can do that too. Just kidding. (Kidding on the square, if you will. Al Franken jokes amuse me.)

1 comment:

Erin said...

You're so funny! Dad, did you have a heart attack when you read the title?!

I'm glad you got your stuff from Ben, he emailed me a couple months ago about it. :)