Thursday, 31 July 2008

What HIV orphans really mean....

You have a society where kids haven't been to school and therefore can't fulfill even basic jobs ... a society where a large proportion can have anti-social instincts because their lives will have been so hard. You have a generation of children who will be more vulnerable to exploitation and to disease because they won't have the same sense of self-worth....Mr. Stephen Lewis, UN special envoy for HIV/AIDS in Africa 2001

Sub-Saharan Africa - 2008 report on the global AIDS epidemic

An estimated 1.9 million people were newly infected with HIV in sub-Saharan Africa in 2007, bringing to 22 million the number of people living with HIV. Two thirds (67%) of the global total of 32.9 million people with HIV live in this region, and three quarters (75%) of all AIDS deaths in 2007 occurred there.
Sub-Saharan Africa’s epidemics vary significantly from country to country in both scale and scope. Adult national HIV prevalence is below 2% in several countries of West and Central Africa, as well as in the horn of Africa, but in 2007 it exceeded 15% in seven southern African countries (Botswana, Lesotho, Namibia, South Africa, Swaziland, Zambia, and Zimbabwe), and was above 5% in seven other countries, mostly in Central and East Africa (Cameroon, the Central African Republic, Gabon, Malawi, Mozambique, Uganda, and the United Republic of Tanzania).

Recent epidemiological trends
Most epidemics in sub-Saharan Africa appear to have stabilized, although often at very high levels, particularly in southern Africa. Additionally, in a growing number of countries, adult HIV prevalence appears to be falling. For the region as a whole, women are disproportionately affected in comparison with men, with especially stark differences between the sexes in HIV prevalence among young people.
In southern Africa, reductions in HIV prevalence are especially striking in Zimbabwe, where HIV prevalence in pregnant women attending antenatal clinics fell from 26% in 2002 to 18% in 2006.
In Botswana, a drop in HIV prevalence among pregnant 15–19-year-olds (from 25% in 2001 to 18% in 2006) suggests that the rate of new infections could be slowing. The epidemics in Malawi and Zambia also appear to have stabilized, amid some evidence of favourable behaviour changes and signs of declining HIV prevalence among women using antenatal services in some urban areas.
HIV data from antenatal clinics in South Africa suggest that the country’s epidemic might be stabilizing, but there is no evidence yet of major changes in HIV-related behaviour. The estimated 5.7 million South Africans living with HIV in 2007 make this the largest HIV epidemic in the world. Meanwhile, the 26% HIV prevalence found in adults in Swaziland in 2006 is the highest prevalence ever documented in a national population-based survey anywhere in the world.
In Lesotho and parts of Mozambique, HIV prevalence among pregnant women is increasing. In some of the provinces in the central and southern zones of the country, adult HIV prevalence has reached or exceeded 20%, while infections continue to increase among young people (ages 15–24).
HIV prevalences in the comparatively smaller epidemics in East Africa have either reached a plateau or are receding. After dropping dramatically in the 1990s, adult national HIV prevalence in Uganda has stabilized at 5.4%. However, there are signs of a possible resurgence in sexual risk-taking that could cause the epidemic to grow again. For example, the proportion of adult men and women who say they had sex with a person who was not a spouse and did not live with the respondent has grown since 1995 (from 12% to 16% for women and 29% to 36% for men). Most of the comparatively smaller HIV epidemics in West Africa are stable or are declining—as is the case for Burkina Faso, Côte d’Ivoire, and Mali. In Côte d’Ivoire, HIV prevalence among pregnant women in urban areas fell from 10% in 2001 to 6.9% in 2005. The largest epidemic in West Africa—in Nigeria, the continent’s most populous country—appears to have stabilized at 3.1%, according to HIV infection trends among women attending antenatal clinics.
Main modes of HIV transmission
Heterosexual intercourse remains the epidemic’s driving force in sub-Saharan Africa. The high rate of sexual transmission has also given rise to the world’s largest population of children living with HIV. However, recent epidemiological evidence has revealed the region’s epidemic to be more diverse than previously thought.
Heterosexual intercourse related to serodiscordant couples
According to Demographic and Health Surveys in five African countries (Burkina Faso, Cameroon, Ghana, Kenya, and the United Republic of Tanzania), two thirds of HIVinfected couples were serodiscordant, that is only one partner was infected. Condom use was found to be rare: in Burkina Faso, for example, almost 90% of the surveyed cohabiting couples said they did not use a condom the last time they had sex.
A separate, community-based study in Uganda has shown that, among serodiscordant heterosexual couples, the uninfected partner has an estimated 8% annual chance of contracting HIV. Strikingly, in about 30% – 40% of the serodiscordant couples surveyed, the infected partner was female. Indeed, it appears that more than half of the surveyed HIV-infected women who were married or cohabiting had been infected by someone other than their current partner.
Sex work
Sex work is an important factor in many of West Africa
’s HIV epidemics. More than one third (35%) of female sex workers surveyed in 2006 in Mali were living with HIV, and infection levels exceeding 20% have been documented among sex workers in Senegal and Burkina Faso. Sex work plays an important, but less central, role in HIV transmission in southern Africa, where exceptionally high background prevalence results in substantial HIV transmission during sexual intercourse unrelated to sex work.
Injecting drug use
Injecting drug use is a factor to some extent in several of the HIV epidemics in East and southern Africa, including Mauritius
, where the use of contaminated injecting equipment is the main cause of HIV infection. In various studies, about half of the injecting drug users tested in the Kenyan cities of Mombassa (50%) and Nairobi (53%) were HIV positive.
Sex between men
Several recent studies suggest that unprotected anal sex between men is probably a more important factor in the epidemics in sub-Saharan Africa than is commonly thought. In Zambia, one in three (33%) surveyed men who have sex with men tested HIV-positive. In the Kenyan port city of Mombasa, 43% of men who said they had sex only with other men were found to be living with HIV. HIV prevalence of 22% was found among the 463 men who have sex with men who participated in a study in Dakar, Senegal.

Friday, 25 July 2008

HIV drugs 'add 13 years of life'

Life expectancy for people with HIV has increased by an average of 13 years since the late 1990s thanks to better HIV treatment, a study says.
Researchers said it meant HIV was now effectively a chronic condition like diabetes, rather than a fatal disease, the Lancet reported.
The team, involving Bristol University staff, looked at over 43,000 patients.
The study found a person now diagnosed at 20 years old could expect to live for another 49 years.
But the Antiretroviral Therapy Cohort Collaboration, which includes scientists from across Europe and Northern America, warned this was still short of the life expectancy for the wider population which stands at about 80.
These advances have transformed HIV from being a fatal disease, which was the reality for patients before the advent of combination treatment, into a long-term chronic condition
Professor Jonathan Sterne, lead researcher
Antiretroviral treatment for HIV consists of drugs which work against the infection itself by slowing down the replication of the virus in the body.
This method of therapy was introduced in the 1990s, but has since become more effective and better tolerated.
The researchers looked at life expectancy during three time periods after the introduction of the drugs - 1996-9, 2000-2 and 2003-5 - in high income countries.
Just over 2,000 patients died during the study periods.
They found that while patients aged 20 diagnosed in the 1990s could expect to live another 36 years, that had increased by 13 years by 2003-5.
During the middle time period, life expectancy stood at an extra 41 years.
Success
Lead researcher Professor Jonathan Sterne said: "These advances have transformed HIV from being a fatal disease, which was the reality for patients before the advent of combination treatment, into a long-term chronic condition."
He added the development was a "testament" to the success of the anti-HIV drugs.
But the researchers warned those diagnosed later in the course of the infection had a much shorter life expectancy.
Marc Thompson, deputy head of health promotion at the Terrence Higgins Trust, said: "HIV medication has become much more effective since the early days.
"There has been great progress, but research needs to continue, especially for those who have developed resistance to some drugs and are running out of options."
But he added the study also highlighted the need for early diagnosis, pointing out an estimated a third of people with HIV do not know they have it.
Deborah Jack, of the National Aids Trust, said: "Hopefully, this study will encourage more people to come forward for testing but we need to better educate doctors about the signs and symptoms to look for.
"Society also needs to catch-up with the fact that HIV is a long-term condition that thousands of people in the UK are living with everyday.
"HIV is not deserved of the fear or stigma that still surrounds it."

Amazing how this is not so in the motherland.

Thursday, 24 July 2008

The Child Rights that are not

Last night I gave a talk titled Holding up half the sky - pain in my heart. It was a very difficult talk to work on very emotional and I needed so much emotional support preparing and presenting it. I would like to thank all my friends who came and the new friends I made. The people who traveled from so far off from York to come and listen I am so humbled that you might honour me so.

Robert Half once said "When one teaches, two learn"
My talk followed the lives of two HIV positive Zimbabweans living in Zimbabwe with the current socio-economic conditions. I will post the video for those who would like to see. I will ignore the life of the gentleman in the video and focus on Angeline and her daugther Beauty. Angeline a single mother HIV positive had noone to look after her when she was really ill. She looked to her 10 year old daughter Beauty.

Beauty as the strong african girl she is rose to the challenge. In certain circles it is admirable to some it is amazing but at the end of the night I was a whole list of Human Right abuses no one is talking about. So I will talk about them. In writing this I refer a lot to the Convention of the Rights of the Child which makes particular referance to the State. I will ask you at this time to bear in mind that the government of Zimbabwe is currently unable to provide a lot of what it signed up to but I would like to draw you to Article 24 of the same convention which says '1. States Parties recognize the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services.
2. States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:
(a) To diminish infant and child mortality;
(b) To ensure the provision of necessary medical assistance and health care to all children with emphasis on the development of primary health care;
(c) To combat disease and malnutrition, including within the framework of primary health care, through, inter alia, the application of readily available technology and through the provision of adequate nutritious foods and clean drinking-water, taking into consideration the dangers and risks of environmental pollution;
(d) To ensure appropriate pre-natal and post-natal health care for mothers;
(e) To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents;
(f) To develop preventive health care, guidance for parents and family planning education and services.
3. States Parties shall take all effective and appropriate measures with a view to abolishing traditional practices prejudicial to the health of children.
4. States Parties undertake to promote and encourage international co-operation with a view to achieving progressively the full realization of the right recognized in the present article. In this regard, particular account shall be taken of the needs of developing countries. '
Those needs have been met by aid and development agencies.

The convention of the rights of the child states in Article 3 that 'In all actions concerning children, whether undertaken by public or private social welfare institutions, courts of law, administrative authorities or legislative bodies, the best interests of the child shall be a primary consideration.'

When you look at Beauty legally she is a child but in every other aspect she is no longer a child. Looking at her situation what is within her best interests? Are those interests I think are best for her realistic in her own world? Let's Explore.

Beauty at age 10 is looking after her terminally ill mother. She has no protective clothing whatsoever in all the work she does. She bathes her mother. Changes and washes linen when need be. In any other society Angeline should be taken to a hospice but this is in Zimbabwe 2007 that is a luxury mother and daughter cannot consider. If she must look after an ailing person a young child must be presented with protective clothing. Some training on how to protect herself from contamination would go a long way.
Article 17 of the CRC says: 'States Parties recognize the important function performed by the mass media and shall ensure that the child has access to information and material from a diversity of national and international sources, especially those aimed at the promotion of his or her social, spiritual and moral well-being and physical and mental health. '

Beauty cooks for her mother and siblings forget the fact that at 10 she is the sole supporter of 4 individuals an adult included. They survive on Sadza and sugar beans. These two foods give her nothing but starch. Different organisations in Zimbabwe are giving food. It is very admirable and I along with a lot of people in Zimbabwe am very grateful for that. Sadza is top on any family's food list and families will go all out to get it. Would it be possible to add more variety to the food. Instead of a 50kg bag of beans how about cutting that to 25kg investing in a CBO and aiding them to have a community vegetable patch to aide people like beauty.
My point in this is if you take to helping why not do it in such a way that if qualitative instead of quantitative. I am also of the opinion that a qualitative approach creates a self sustaining community not always waiting for hand outs.
Article 24:2 c points out that 'States Parties shall pursue full implementation of this right and, in particular, shall take appropriate measures:(c) To combat disease and malnutrition, including within the framework of primary health care, through, inter alia, the application of readily available technology and through the provision of adequate nutritious foods and clean drinking-water, taking into consideration the dangers and risks of environmental pollution '

Beauty is still in school that is something to be grateful for. She lives in a semi urban area. Children in rural Zimbabwe usually get to school so tired from walking long distances to school. Beauty gets to school tired from the morning chores then the walk. Her breakfast is whatever she can salvage from the previous night's meal. Now we have her in school tired and severly malnourished what benefit are those few hours in school? Is it of any benefit to her to go to school? In addition to her right to education Beauty has the right Article 28: 1(e) to have someone 'Take measures to encourage regular attendance at schools and the reduction of drop-out rates. ' Her right to education right is being met but how effective and real is it? A lot of aspects of her life have to change to make the education right real.

Beauty is in primary school now and will be going to secondary school. Some one has to pay for that. With the death of her mother and absence of a guardian what line does she take in her life? She has no resources available to her to earn a living. She has noone to turn to. Noone to look after.

Friday, 18 July 2008

Alicia keys in Africa : journey to the motherland Part 1

Alicia keys in Africa : journey to the motherland Part 2

Alicia keys in Africa : journey to the motherland Part 3

Alicia keys in Africa : journey to the motherland Part 4

Alicia keys in Africa : journey to the motherland Part 5

Alicia keys in Africa : journey to the motherland Part 6

Thursday, 17 July 2008

Sharon Speaks at Child Participation Seminar...

http://docs.google.com/Presentation?docid=dct62w4m_2656rtvdd7&hl=en

Sharon doing what she does best....

Talking...

Sharon on BBC Radio York

This Sunday 20 July 2008 Breakfast Show talking about HIV and AIDS in Zimbabwe....
http://www.bbc.co.uk/northyorkshire/local_radio/

What do you see in the mirror?

I spent the weekend with an interesting group of people. Zimbabweans who have left home and lived all over the world. Absorbed so much of the world they have seen, speak the languages of the world and quiet frankly they fit into any world they find themselves in. Good? Bad? Wonderful to be all that but when I take my shoes off I want to see Sharon. I want all the masks off all the fanciness off n jes be me. I like that grounds me...what do u see in the mirror at the end of the day?

Friday, 11 July 2008

Ndinokudai amai vangu

I have found a force stronger than any weight of depression. A force that scatters the clouds in any situation. A force that dares and scares the word impossible. It is you mhamha. You have fought wars for me the whole world dared not fight. You stood where men could not stand for me. You trod where lions dare not go for the sake of me. You moved mountains to make a way for me.
Bulelani mama wani. Nakurata ma and may the heavens alwaise stay open for you and rain down more blessings than you can hold in ur heart and love only then can you give more to more people and be loved by all because that is your place in the sun...basking in the love of many.

Audius Mtawarira-Hold On [Shona Version]

For my mother

Thursday, 10 July 2008

Ndinotenda...


You never give yourself enough credit so I will.... You have been very significant in the person I am today. I shall forever be grateful to you both. May God bless you ever so much for who you are and who I have become because He allowed me to meet you...