WORLD AIDS DAY 2014

We all have an HIV story. This could have been mine.

 

“Let us be the ones who say we do not accept that a child dies every three seconds simply because he does not have the drugs you and I have. Let us be the ones to say we are not satisfied that your place of birth determines your right to life. Let us be outraged, let us be loud, let us be bold.” – Brad Pitt, Actor & Social Justice Activist

 

I was born in the dawn of a new country.

In 1980, 92 years after King Lobengula of the Ndebele Kingdom sold mining rights for weaponry and inadvertently invited colonialism into his nation, 90 years after the European settlers took Lobengula’s land as a colony and ended centuries of tribal self – rule, 84 years after the First Chimurenga (revolutionary war) between the African majority warriors and the European colonialists, 14 years after the start of the Second Chimurenga, and exactly 5 years before my birth, a newly emancipated people celebrated the death of Rhodesia, a rebellious apartheid state run by White-Supremacist Ian Smith, and the re-birth of Zimbabwe, a country seven centuries in the re-making.

I am a member of the “Born-Free” generation, the first children of Zimbabwe to have never been called Rhodesian, the first to live under majority rule, the first with no memory of war, no memory of discrimination. My Zimbabwe was self-governing and prosperous and socialist; we had a minimum wage and job security, universal health care and free education. Unbeknownst to any of us at the time, the 1980s would also give rise to a new virus that would play a fundamental role in the unraveling of our newly prospering Utopia.

Zimbabwe’s first case of HIV was diagnosed in 1985[1]. During that first decade, the virus went unchecked, aided by the euphoria-induced ignorance of the public, the business of creating a new nation, the signs of economic troubles to come, the growing political instability fueled by tribal disputes, a not-so-secret politically motivated genocide against the Ndebele people by the ruling Shona leaders, a conservative social culture uncomfortable with open discussion about sexual health & the accepted practice of polygamy.

By the late 1980s, 10 percent of Zimbabweans were infected with HIV and this number rose in the mid-1990s to an astounding 30 percent of the population[2]. Zimbabwe became the nation with the third highest number of infected people and by 2003, two million Zimbabweans would be infected2. In 2007, it was estimated that one Zimbabwean became infected with HIV every three minutes2, as the virus reached epidemic proportions.

 

“It all started as a rumor… Then we found we were dealing with a disease. Then we realized that it was an epidemic. And now we have accepted it as a tragedy.”  – Dr Samuel I Okware, Chief Epidemiologist in Kampala, Uganda[3]

 

Although HIV was introduced to Zimbabwe, and most of Southern Africa, in the 1980s, West & Central Africa had already been dealing with the first heterosexually-spread HIV epidemic for about a decade and East African infection rates would reach epidemic proportions by the early 1980s[4]. The virus would spread rapidly in the East, aided by majority male urban centers, oppression of women, significant prevalence of sexually transmitted diseases and prostitution. By 1986, 85 per cent of the sex workers in Nairobi were infected[5]. In Uganda, researchers were making links between what they knew to be “Slim Disease” and a newly identified virus prevalent in the homosexual population in the USA. This connection would come slowly and too late for many. Toward the end of the 1980s Southern African countries, including Zimbabwe, were poised to overtake East Africa in the spread of HIV & sub-Saharan Africa would become the epicenter of a devastating worldwide epidemic1. By the end of the decade, it was clear a new crisis was emerging: 30 per cent of all pregnant women in Uganda would be infected and with them, the first generation of children born with the disease would arise1.

 

“He who has health, has hope; and he who has hope, has everything.’ – Thomas Carlyle, Philosopher & Historian

 

Even prior to the devastating HIV/AIDS epidemic, being a woman of child-bearing age in sub-Saharan Africa was a perilous condition, pre-disposing her to premature death or maternity-related lifetime illness with limited access to appropriate healthcare. During the 1970s and the 1980s, maternal mortality rates began to improve across the Region as governments prioritized primary health care, including antenatal and emergency obstetric services[6]. Despite these improvements, maternal mortality rates in the Region were significantly higher than every other Region in the world and represented a serious international health crisis. The advent of the HIV/AIDS epidemic was devastating to an already dire situation. By the early 1990s, fifteen years into the epidemic, 150 000 sub-Saharan African women died annually of maternity causes, about one every 3.5 minutes[7]. That mortality rate likely resulted in nearly one million motherless children a year4.

The escalation of this already severe public health concern became an international priority and was named in the United Nations Millenium Development Goals (MDG). “MDG 5: Improve Maternal Health” called for a 75 per cent reduction in the maternal mortality ratio between 1990 and 2015 and universal access to reproductive health by 2015[8]. To date, there has been some success in reducing the scale of the problem. The maternal death rate in sub-Saharan Africa dropped by 41 per cent from a rate of 850 deaths per 100 000 live births in 1990 to a regional average of 500 deaths per 100 000 live births in 2010[9]. In reality, there were 287 000 worldwide maternal deaths in 2010 alone, 56 per cent of which occurred in Sub-Saharan Africa1. Of the 19 000 maternal deaths due to HIV globally, sub-Saharan Africa registered 17 000 and at 10 per cent, represents the Region with the highest proportion of maternal deaths due to HIV1. A woman in sub-Saharan Africa has a 1-in-16 chance of dying due to pregnancy or childbirth over her lifetime. If she lived in a Developed nation, her risk would be 1-in-2800[10]. The deaths of these women in sub-Saharan Africa are almost always preventable.

I am a daughter of sub-Saharan Africa, generations in the making.

I cannot tell you the story of my female ancestors. A cultural history of patriarchy, poverty, struggle and oppression means that their stories have not been told, their struggles and victories have not been preserved. But in the unsung lives of the women of sub-Saharan Africa, I see so clearly what could have been mine.

HIV is no longer a death sentence for some. We can still do more to make living with HIV more prevalent than dying from it.

For all of us.

 

“When asked if I am pessimistic or optimistic about the future, my answer is always the same: If you look at the science about what is happening on earth and aren’t pessimistic, you don’t understand data. But if you meet the people who are working to restore this earth and the lives of the poor, and you aren’t optimistic, you haven’t got a pulse. What I see everywhere in the world are ordinary people willing to confront despair, power, and incalculable odds in order to restore some semblance of grace, justice, and beauty to this world.” – Paul Hawken, Environmentalist and Author

Twitter: @thereisaiditorg || @plumandmustard

[1] AIDS in Zimbabwe: How socio-political issues hinder the fight against HIV/AIDS Jovonna Rodriguez, Emory endeavours in world history, Mar 2007, p4

[2] AIDS in Zimbabwe: How socio-political issues hinder the fight against HIV/AIDS Jovonna Rodriguez, Emory endeavours in world history, Mar 2007, p5

[3] New Vision, 4 September 1993 in “The African Aids Epidemic: A History” John Illiffe, James Currey Oxford, 2006, p25

[4] History of HIV/AIDS in Africa http://www.avert.org/history-hiv-aids-africa.htm#footnote1_c220hg8

[5] History of HIV/AIDS in Africa http://www.avert.org/history-hiv-aids-africa.htm#footnote1_c220hg8

[6] In Her Lifetime: Female Morbidity and Mortality in Sub-Saharan Africa C.P. Howson, P.F. Harrison, M. Law, Institute of Medicine, 1996, p85

[7] The Health of the People: The African Regional Health Report WHO Regional Office for Africa, 2006, p19

[8] United Nations Millenium Development Goals http://www.un.org/millenniumgoals/aids.shtml

[9] Trends in Maternal Mortality: 1990 to 2010 WHO, UNICEF, UNFPA and The World Bank estimates, 2011, p1

[10] The Health of the People: The African Regional Health Report WHO Regional Office for Africa, 2006, p19

There. I said it. Your turn.

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