LESOTHO: Time to talk about sex and HIV

Photo: Eva-Lotta Jansson

Young girls often engage in sex with older men for financial reasons

MASERU, – Having more than one sexual relationship at the same time is driving the spread of HIV in small landlocked Lesotho. The health sector has long suspected this, but a new report by the National AIDS Commission (NAC), in partnership with UNAIDS and the Ministry of Health and Social Welfare, has confirmed it.

The report, Gender and Multiple and Concurrent Sexual Partnerships in Lesotho, found that 76 percent of men and 82 percent of women knew that having only one partner reduced HIV risk, but they were reluctant to limit themselves.

Now a new awareness campaign aims to get people talking about the taboo subject of HIV and how to prevent it. “Changing behaviour begins with communication,” said Ma-’Neheng Ninie Mopeli, the NAC’s Director of Services.

“People know about HIV prevention but they are afraid to talk about it, so mothers do not discuss the practical application of their knowledge with their daughters, or husbands with wives.”

Open and frank discussion cannot start soon enough; 23 percent of Lesotho’s adult population are infected with HIV, the third highest prevalence in the world.

The study on multiple concurrent partners (MCPs), conducted in focus group discussions and interviews with participants of various ages and socioeconomic backgrounds at five sites in Lesotho, found that poverty was among the factors driving the practice. Young girls often engaged in sex with older men for financial reasons, providing HIV with a major entry point into the younger generation.

“Financial neglect, along with domestic discord, physical and emotional abuse, were mentioned as some of the reasons for seeking other partners,” the report said. Marriage offered no protection from HIV infection; in fact, it was a major source of risk for women married to unfaithful husbands.

People know about HIV prevention but they are afraid to talk about it

Cultural factors also played a role; men were considered the dominant partners in marriage by virtue of the dowry they traditionally paid to brides’ families.

Unwillingness to use condoms stemmed from a perception that they implied a lack of trust. “It is critical to help people understand that condoms are used even in trusting relationships.” The study also recommended “more focus on fidelity among married partners” if anti-AIDS efforts were to succeed.

Getting the word out

“Having the data is the starting point. We suspected that MCP is a major driver, and now we know; now we have the process of getting the word out,” said the NAC’s Mopeli.

Media organizations, sports organizations, faith-based groups, and youth groups will all be briefed on how to disseminate the study’s findings. “Men need to talk to men, telling each other not to be ashamed to carry a condom, and women should talk to women about such things as being frank about sexual matters with their sisters, daughters and neighbours. Then we will bring those groups together,” said Mopeli.

Health motivators often ran into obstacles, such as needing permission from parents to speak to children about sexual matters, but encouraging people to talk about HIV among themselves would help overcome these.

“Having different group discussions is also important for cultural reasons,” Mopeli said. “It is inappropriate to discuss condom use and such matters with the elderly, but there are things they too must know.”

Mohau Mokoatsi, a UNAIDS programme officer in Lesotho, said respect for cultural traditions would be vital to successfully getting the message out. “We have revised our national strategy to incorporate chiefs and traditional leaders; it is these authority figures who will take the message to their subjects,” he told IRIN/PlusNews.

Lacking large numbers of facilitators, the government is relying on existing programmes to spark a nationwide debate about MCPs. “When the agriculture ministry agents go out to talk with the farmers about fertilizer and irrigation, then they can also talk about AIDS. We will train them to spread the message,” Mopeli said.

The next step will be to ensure that people know where to find condoms and counselling services so they can apply what they have learned.

jh/ks/he source.irinnews.org

ZIMBABWE: Anna Matopodza, “When I tell people I am a grandmother, they do not believe me”

Photo: Glenna Gordon/IRIN

“When I dance I have so much energy”

HARARE,  – When Anna Matopodza, 55, from a village in the Buhera district of Manicaland Province, Zimbabwe, found out she was HIV-positive, she was anxious about who would look after her five children when she died. The thought of death haunted her for months; then she joined dance group and travelled around the world, teaching people about HIV/AIDS through song and dance.

“I tested HIV positive in 1996, after the death of my husband. My husband had been sick for a very long time; we were always in and out of hospital but I had never got the opportunity to get tested. I got tested after some counselling from an organization called Family Care Trust-Nyanga (Fact-Nyanga).

“Back then, in 1996, we didn’t have the New Start Centres that are now offering voluntary counselling and testing around the country, so for someone to get tested it was a very difficult and an expensive thing.

“The result came back positive. I didn’t even know what that meant, except that I knew I had a disease that had no cure, no treatment, and that I would soon die in the same painful way my husband had died.

“My concern was for my four girls – I was afraid that after I had died they would be forced to get married early and also expose themselves to the disease. I lost a lot of weight just thinking about all these things.

“When I joined Tsungai ['be strong' in the Shona language] support group I had no idea what to expect; I just joined because I was probably looking for answers. I found peace at this support group because we were no longer talking in hushed tones about HIV/AIDS.

“While in this support group I heard about the Murambinda Peer Educators Dance Group and I decided to join them. I wanted to let others know about this disease before it was too late.

“The children I was worried about years ago are all grown up now. The four girls are married and have children of their own. They all completed their education and they have good jobs.

“I didn’t think I would live to see my children grow up, or to see my 14 grandchildren. My fifth child – my only son – is still at home with me, doing his studies.

“Many people died of stress in the 1990s because there was not much information about HIV/AIDS … this is why I am part of Murambinda Dance Group, as old as I am.

“When I tell people I am a grandmother, they do not believe me because when I dance I have so much energy – there is no old and young when we are fighting HIV!”

st/kn/he source.irinnews.org

SWAZILAND: TB-HIV services needed to lower world’s highest rates

Photo: Gary Hampton/World Lung Foundation

Fifty-eight percent of TB patients completed their treatment last year

MBABANE,  – Swaziland not only has the world’s highest HIV prevalence rate, it now also has the highest tuberculosis (TB) rate, but health officials warn that not enough is being done to integrate TB and HIV services.

Last week the Ministry of Health and Médecins Sans Frontières (MSF), the international medical humanitarian organization, brought together health experts to look at practical solutions for the small landlocked country.

One in four adults is infected with HIV; by the end of 2007 an estimated 170,000 people were living with HIV, and every year an estimated 13,000 people develop TB, the primary opportunistic disease in HIV-positive people.

“When you look at the history of TB in Southern Africa you see that it was considered a very serious disease in the 1950s, but seemed to be under control by the 1980s; but with the arrival of HIV and AIDS, TB rates have really gone out of control,” said Prof Alan Whiteside, head of the Health Economics and HIV Research Division (HEARD) at the University of KwaZulu-Natal in South Africa.

Themba Dlamini, manager of Swaziland’s National TB Control Programme, said 80 percent of Swaziland’s TB cases were also HIV-positive.

But with governments focused on HIV/AIDS, TB has not been getting enough attention.

“Part of the problem is we’ve been very good at mobilizing for HIV and AIDS, and we sort of forgot about TB as we did that. Unfortunately, I don’t think the people mobilizing for TB have been as articulate and as powerful as those mobilizing for HIV and AIDS – we need to put TB higher on the public agenda,” Whiteside told IRIN/PlusNews.

Swaziland’s Health Minister, Benedict Xaba, reminded delegates that although the country provided free TB medicines, other costs, such as hospital fees and transport, made it difficult for many people to access health services.

More on TB

Turning the tide against drug-resistant TB

Tackling HIV and TB – where there’s a will, there’s a way

“It’s TB that’s killing people”

The burden of drug-reistant TB

“There are several issues that Swaziland needs to face. Access to care is particularly important … so people who show signs of symptoms can be checked immediately. Free consultation is absolutely imperative – we must think of free care from diagnosis to clinical cure,” urged Dr Mario Raviglione, Director of the Stop TB Department of the World Health Organization (WHO).

Raviglione urged the country to step up efforts to integrate TB and HIV services. “It doesn’t make any sense for a person taking TB drugs and ARVs [antiretrovirals, to treat HIV] to go to two separate doctors. These must be integrated.”

About 58 percent of TB patients completed their six-month course of treatment last year, falling far short of the 85 percent target recommended by WHO. International guidelines also set a 70 percent detection target for TB, but in Swaziland the case detection rate is below 60 percent.

The good news is that, unlike HIV/AIDS, TB is curable. “I know people living with HIV and TB, and their TB has been dealt with,” noted Whiteside. “It is a community message we need to get out – that we are capable of eliminating the scourge of TB in your community.”

jh/kn/he source.irinnews.org

KENYA: Cervical cancer, little-known killer of HIV-positive women

Photo: Tugela Ridley/IRIN

The HPV vaccine is too expensive for most Kenyan women

 

 

 

 

 

 

NAIROBI,  – Three years after being diagnosed with HIV, Alice Mworia, 28, went for a routine medical check-up during which she told the nurse she had noticed an unusual vaginal discharge; a test revealed she had pre-cancerous lesions on her cervix that could develop into cancer if untreated.

“I was experiencing a bad smell from my private parts and I wondered whether it was because I was HIV-positive; I could not keep quiet any more and I shared with one of the nurses and she referred me to the doctor,” Mworia told IRIN/PlusNews. “I did not even know there was anything called cervical cancer, which I was informed can kill very easily.”

According to the UN World Health Organization (WHO), some 2,635 Kenyan women are diagnosed with cervical cancer every year, with 2,111 dying from the disease, making it the most prevalent cancer among women in the country. About 38.8 percent of women in the general population are estimated to harbour cervical human papillomavirus (HPV) infection – a leading cause of cervical cancer – at any given time.

High risk, low knowledge

For cervical HPV infection to progress to cancer, certain co-factors must be in place, including smoking, long-term hormonal contraceptive use and co-infection with HIV. However, medical professionals strongly recommend that all women over the age of 21 be screened for cervical cancer.

“Women who are HIV-positive have weak immune systems and this makes them very susceptible to persistent human papillomavirus that develops into cancer of cervix,” said Lucy Muchiri, a senior lecturer in human pathology at the University of Nairobi’s College of Health Sciences and a member of the sub-Saharan Africa Cervical Cancer Working Group.

“It takes a relatively shorter time for the HPV virus to develop into full-blown cancer of the cervix for women who have the HIV infection … It would take relatively longer in women who are not infected with HIV.”

Pap smear tests – which check for changes in the cells of the cervix – are available at most district health facilities in Kenya, but according to WHO, fewer than 6 percent of women access them.

“I think many women die from the disease for a number of reasons – one is ignorance because knowledge about the disease among women and in the general population is very low and it is mistaken for other diseases,” she said. “It is appalling that despite most cancer-related deaths in women happening because of cervical cancer, it is the least talked about or even known by people, including women.”

According to Francis Kimani, director of medical services at the Ministry of Health, Kenya is planning a screening programme for early detection and treatment of cervical cancer as well as a widespread education campaign.

Education gap

“I think our best bet is to carry out education to let people know about the disease and that early detection of it can be very helpful,” Kimani told IRIN/PlusNews. “It is true that not many people – especially in rural areas – know about the disease.”

Studies have shown that HPV is higher among women who have multiple sexual partners and unprotected sex.

“Maybe to prevent it in the first place, the same methods used in combating HIV, like condom use, abstinence and keeping to one faithful partner, should be encouraged in this case too,” Muchiri suggested.

It is appalling that despite most cancer-related deaths in women happening because of cervical cancer, it is the least talked about or even known by people, including women

She noted that the government also needed to invest in making the HPV vaccine – which protects against four major types of HPV, including two types that are responsible for 70 percent of cervical cancers – widely available in public hospitals.

Vaccine availability

The Kenya Pharmacy and Poisons Board approved the sale of an HPV vaccine in the country in 2007, but its availability is extremely limited and it is still prohibitively expensive for most Kenyans.

“HPV is a sexually transmitted virus and with the vaccine in place, it is important to encourage parents to take their young girls between the ages of nine and 15 to be vaccinated before they debut into sex,” she said.

A recent study by the local NGO, Centre for the Study of Adolescence, found that four in 10 Kenyan girls had sex before the age of 19, many of them as early as 12.

“Once they [women] become sexually active, it is important to encourage [them] to go for Pap smear tests or visual detection of the pre-cancerous lesions but even vaccination at this stage is still feasible so long as one has not contracted the virus,” Muchiri added.

ko/kr/mw source.irinnews.org

Ethiopian opposition packs no punch as elections loom

Ethiopian Prime Minister Meles Zenawi. Photo/FILE

By BARRY MALONE

 

ADDIS ABABA, Tuesday

When Ethiopia’s opposition leaders were freed from jail in 2007, the three most prominent were hailed by fanatical supporters as leaders-in-waiting for sub-Saharan Africa’s second most populous nation.

Now, Ms Birtukan Mideksa sits in a prison cell, Mr Berhanu Nega is exiled in the United States, convicted in absentia of plotting a coup, and Mr Hailu Shawel only recently re-appeared in public.

That leaves many Ethiopians wondering where a challenge to the almost 20-year-old government of Prime Minister Meles Zenawi could come from when the country holds elections next May for the first time since a disputed 2005 poll ended in violence.

Despite accusations of a crackdown on dissent, diplomats in the capital say the West would be comfortable with Mr Meles staying on — as long as he remains a loyal ally in the volatile Horn of Africa and liberalises his potentially huge economy.

Secular Ethiopia is Washington’s key supporter in the region and sent troops into neighbouring Somalia in 2006 to oust an Islamist group which had seized the capital.
“Most Western governments want Meles to continue because there is no alternative in the opposition,” said one diplomat in Addis Ababa who did not want to be named. “As long as the elections are semi-democratic, they’ll probably stay quiet, keep giving aid, hope for liberalisation of the economy and leave full democracy for later,” he said.

Foreign investors, who are showing interest in exporting commodities and exploring Ethiopia for probable oil and gas deposits, want stability, analysts say. If the opposition takes power, the future would be uncertain and investments delayed as foreign governments and lenders jostle for influence.

Rich nations are also hoping the government will relinquish control of its potentially lucrative telecommunications and banking industries in a nation of more than 80 million people.

Eight opposition parties are trying to register as a coalition to contest the polls under the name Medrek, or the Forum, while retaining their own structures and leadership.

But most people in the country, and even some opposition leaders, agree that Mr Meles’ ruling Ethiopian People’s Revolutionary Democratic Front will easily win in 2010. The opposition says this is because candidates are routinely intimidated and jailed. The government says the opposition parties make the accusations because they know they have no chance of victory and want to discredit the poll.

“The Ethiopian People’s Revolutionary Democratic Front has done its best to weaken the opposition in view of the 2010 elections,” Mr Rene Lefort, an Ethiopia analyst, told Reuters. “Fear of repression is the main factor which refrains most opposition members from campaigning actively.”

Birtukan, Berhanu and Hailu, leaders of a previous opposition coalition, were jailed in 2005 with other figures after they were convicted of inciting supporters to march on state buildings when the government declared victory.

About 200 protesters were killed by police and soldiers on the streets of the capital in that unrest. Ethiopia has never had a peaceful transition of power. Mr Meles himself took over in 1991 after a rebel group led by him and others overthrew a brutal communist regime.

The opposition leaders were pardoned and released in 2007, along with some journalists and aid workers, on condition they take responsibility for the violence. But Ms Birtukan, a popular 36-year-old single mother, was jailed for life last December after denying she had accepted blame for the 2005 bloodshed. Authorities said that violated the terms of her pardon.

The government has said it will invite international election observers, most likely from the European Union, and last week agreed a “code of conduct” for next year’s elections with three parliamentary opposition parties.

Medrek — seen as the most significant threat to Meles — refused to take part, demanding bilateral negotiations on issues they say were left out, including electoral board reform.

Diplomats in Addis Ababa are now trying to persuade the opposition coalition to sign the code of conduct deal.

Some ruling party members privately told Reuters they were frustrated a deal could not be agreed, and Birkutan released, so there could be a genuine campaign on Meles’ achievements.

While some 13 million Ethiopians still rely on some form of foreign aid for survival, the government has reduced infant mortality and poverty rates and says the economy has been growing at an annual rate of more than 10 per cent.

“I don’t agree with jailing Birtukan,” a senior Ethiopian People’s Revolutionary Democratic Front member, who did want to be named, told Reuters. “She’s a strong opponent, but Meles is good for Ethiopia and I wanted us to debate openly and show the people our economic achievements.” (Reuters)

 

source.nation.ke

Karzai vows inclusive Afghan government

Afghanistan’s President Hamid Karzai (centre), First Vice President Mohammad Qasim Fahim (left) and Second Vice President Abdul Karim Khalili attend a news conference in Kabul November 3, 2009. REUTERS

 

KABUL, Tuesday (Reuters) – Re-elected Afghan President Hamid Karzai vowed on Tuesday to form an inclusive government after stern warnings from Western supporters he would have to work harder to root out corruption.

Afghan election officials on Monday cancelled a needless presidential run-off vote after Karzai’s only rival, former foreign minister Abdullah Abdullah, withdrew citing serious concerns about the election.

The outcome leaves Washington and other Western supporters to work with a partner whose legitimacy has been questioned, while Karzai himself faces the prospect of having to work with a newly strengthened opposition.

Karzai’s return removes at least one obstacle as US President Barack Obama weighs whether to send up to 40,000 more troops to Afghanistan, where violence this year reached its worst levels since the Taliban were in 2001.

Faced with stern warnings from Obama, Prime Minister Gordon Brown and other Western leaders, Karzai vowed to form an inclusive government.

“My government will be for all Afghans and all those who want to work with me are most welcome,” Karzai said in a nationally televised victory speech.

“There will be crucial changes in our future government. Now we are determined to use all our forces, by any means, to remove this stain (of corruption) from our soil,” he said.

Taliban claim success

Afghanistan endured weeks of political uncertainty after the August 20 first round was marred by widespread fraud, much of it in favour of Karzai, a crisis deepened by a resurgent Taliban who had vowed to disrupt the vote.

The Taliban termed Karzai’s return a farce and vowed to continue its fight to drive foreign forces out of Afghanistan.

The Islamist militants launched sporadic attacks in the first round and vowed to disrupt the run-off. They said their fighters had “paralysed” the electoral process with their attacks, including an assault on a UN guest-house last week in which five foreign U.N. staff were killed.

“Even they were not spared in the U.N. guest house in the heart of Kabul,” the Taliban said in a statement sent to Reuters.

Afghanistan’s government-appointed Independent Election Commission (IEC) called off the vote on Monday, saying it wanted to spare the Afghan people the expense and security risk of a vote with just one candidate.

Obama congratulated Karzai, but told him in a telephone call on Monday he had to get serious in cracking down on corruption and better serving his people.

There are currently around 67,000 U.S. troops and 42,000 allied troops in Afghanistan. A White House spokesman said a decision by Obama on troop levels was still weeks away.

While under a critical eye from the West, Karzai still has plenty of support, especially in the Pashtun-dominated south and east. Hundreds took to the streets in celebration in the western city of Herat on Monday.

But not everyone in the capital was happy with his return.

“Whatever he has done during the last seven or eight years, it will be the same again,” Kabul resident Haji Daulat told Reuters television. “So many people died during his term, and prices went up for everything.”

Karzai has ruled since US-backed Afghan forces toppled the Taliban in 2001.

“The credibility of the Karzai government is not going to be simply decided by this election, it will now be decided by the actions the president takes over the coming days and weeks,” said a Kabul-based Western official who asked not to be named.

 

source.nation.ke

‘Lightning’ strikes Kibaki and Raila

Usain Bolt strikes his trademark pose before an amused President Mwai Kibaki at Harambee House on Monday. Photo/MOHAMMED AMIN

By AYUMBA AYODI

In Summary

• World’s fastest man meets Kenya’s top executives before adopting cheetah

 

Nothing can best describe the historic moment when the fastest man on the planet finally met the fastest animal on earth.

Image Gallery

Jamaica’s multiple world record holder, Usain Bolt, wound up his four-day tour of Kenya with a most memorable day when he met with President Mwai Kibaki and Prime Minister Raila Odinga before adopting a cub cheetah at the world’s famous Animal Orphanage in Nairobi.

Bolt, on a tour courtesy of the Zeitz Foundation, arrived in Nairobi in the early hours of Monday from the Segera Ranch in Laikipia and headed straight to the president’s offices at Harambee House for a meeting with Kibaki.

During the meeting, President Kibaki and the Jamaican champion discussed activities of the Zeitz Foundation which advocates for the sustainable use of the environment.

Conservation

Bolt, who is a global ambassador for sports of the Zeitz Foundation, has been in the country for the official launch of the foundation’s programmes in Kenya and establishment of a conservation programme.

President Kibaki congratulated the athlete and encouraged him to make more visits to the country, saying he was an inspiration to the country’s youth.

The Jamaican then headed for the Kenya Wildlife Services headquarters where he met with the Prime Minister who accompanied him to the launch of the KWS adoption programme called Namayiana, a maasai word for “blessed one.”

Less tense moments

It was sheer delight as Bolt, who holds the 100 metres world record at 9.58 seconds and the 200 metres mark at 19.19 seconds on the track, encountered the cheetah that usually bolts at 112 kilometres per hour in the wild.

Perhaps the guided tour that Bolt took around the Kenya Wildlife Services headquarters somehow calmed down his nerves before the historic meeting with the cheetahs.

There were more appealing and less tense moments when the Jamaican superstar adopted a three-month-old cheetah that was subsequently named “Lightning Bolt” after the Jamaican star’s track nickname.

“I am not afraid of animals any more,” said Bolt as he cuddled “Lighning Bolt” who appreciated the gesture as it suckled mildly the bottled milk offer by the 23-year-old superstar.

To perhaps ward off the encounter with the cheetahs and perhaps the challenge they could pose to his track speed records, Bolt reckoned that his most memorable moment was his encounter with a bull elephant at the Segera Ranch in Laikipia on Sunday.

The Segera Ranch is owned by Zeitz who is also the chief executive of sportswear firm, Puma, Bolt’s competition gear sponsors.

“It was kind of upset and scared as it waved its big ears perhaps a sign that he was not ready to meet Bolt,” said Bolt, who also holds the 4×100m relay record.

Image Gallery

Another interesting moment for Bolt was when their vehicle got stuck in black cotton soil of Segera.

“I guess the driver was not that good,” said Bolt eliciting a lengthy laughter from the crowd.

“I should acknowledge that I enjoyed my stay in Kenya. When I watch Kenya on television, it is shown as a country with lot of sunshine but it’s been chilly and rainy since I got here,” said Bolt.

“I hope to come back and follow up on how little Lightening Bolt is doing.”

Bolt was accompanied by former 110m hurdles world record holder, Colin Jackson from Britain, who, along with the Prime Minister, also adopted animals at the Orphanage. Jackson adopted an eland he named ‘Colin’ while Odinga a Lion’s cub he named ‘Agwambo.’

The party was received at the Kenya Wildlife Services offices by the KWS director, Julius Kipng’etich, before being led to lay wreaths at the Heroes’ Corner in memory of the wildlife guards who died on duty.

They later unveiled a plaque at the Orphanage to launch the KWS adoption programme before taking a brief tour where they also had encounters with lions and leopards.

After the adoptions, Bolt and Jackson were taken for an evening game drive before they flew out last night.

Bolt and Jackson were in Kenya to officiate the launch of Zeitz Foundation’s Africa offices and operations last week.

The Zeitz Foundation chairman, Jochin Zeitz, also received a certificate in recognition for his work.

 

source.nation.ke