Swaziland

The population of the AIDS-riven kingdom of Swaziland, already one of the smallest countries in Africa, has fallen by around a fifth in the last decade, figures showed on Friday.

Swaziland's first Demographic Health Survey has found that 26 percent of sexually active Swazis are infected with HIV. The last prevalence survey, based on tests of pregnant women at antenatal clinics, had found a 38.6 percent HIV infection rate. The new figure was derived from a house-to-house survey by the Central Statistics Office for the Ministry of Health and Social Welfare. Men and women living at selected households were questioned, and their blood taken for anonymous testing.

ITS no secret that people who live mobile lives, such as truck drivers and migrant workers, are more prone to contracting HIV than those who stay in one place, rooted in family and routine.

Swaziland's home-based caregivers are too few and too poorly paid to cope with the growing numbers of bedridden AIDS patients, but in the absence of adequate health facilities and trained professionals, they are seen as the immediate answer to a national emergency.

In response to growing alarm over Swazilands HIV infection rate, a draft law proposing the death penalty for child rape and the intentional transmission of the virus was released this week.

A critical shortage of health professionals in Swaziland is undermining the public health system's capacity to expand its national antiretroviral (ARV) programme, health officials have warned.

Citing deaths they claim are due to the improper introduction of antiretrovirals (ARVs) in Swaziland, AIDS activists have called for an urgent public education campaign and proper testing facilities to monitor patients' reaction to the drugs.

After years of resisting the introduction of antiretroviral drugs (ARVs) in Swaziland, the government bowed to pressure from international donor organisations last year and permitted their distribution. However, what followed has been a confusing and dangerous free-for-all which has reached the point where some activists have called for the drugs to be banned.

At the end of a week-long conference in Swaziland, African educators and US representatives called for further cooperation between the private and public sectors in the fight against HIV/AIDS in schools. We are analysing what works, and stressing innovation and proven successes over formulae, Behuel Ndlovu, director of secondary schools for the Swaziland Ministry of Education, told IRIN. Colette Cowey, an expert on global development issues recommend partnerships between Western and African nations, between the public and private sectors, and between civil society and governments for AIDS mitigation to be achieved through improved education in Africa. Bringing corporate sponsors and NGOs into schools to improve infrastructure, bursaries, curriculum and life skills teaching (which includes sex education and AIDS awareness) was unheard of a decade ago, when all aspects of African education were managed by national education ministries or missionary schools. Non-traditional partners like corporations now contribute funding, skills, services and expertise, technology and intellectual property. A synergy results from these joint efforts, said Cowey. Swaziland's Under-Secretary of Education, Doctor Simelane, gave an example: We have a problem of children being short-changed by the absence of teachers with AIDS. We urge these teachers to apply for sick leave, but they refuse. They fear we'll fire them [but] they cannot be dismissed unless they are absent some weeks. So, they show up from time to time to put in an appearance, and then leave the class without a teacher. The headmaster begs us for a replacement, but replacements can only come when there is an official vacancy. One solution offered by delegates was to train volunteers from the community who could share teaching assignments. One person may have English skills, another might know science. In an emergency like AIDS, which is devastating the ranks of teachers, creative solutions with community involvement is essential, said Dominic Machel, a delegate from Mozambique. Seth Ong'oti, a Kenyan project manager with the Aga Khan Foundation (AKF), specialises in improving the standard of education in Muslim Schools in East Africa through community development. said that they start with a request from a community for support. We have to develop a quality, sustainable programme that targets disadvantaged children, that is acceptable to the community. We come up with what we call the African Cooking Pot: teacher training, the physical building structure to make a good learning environment, and community mobilisation. Grassroots support was achieved by seeking the endorsement of Muslim elders and religious leaders, who approved the project and then passed the information on to their followers. The former vice-chancellor of the University of Swaziland, Dr. Lydia Makhubu, stressed the need for introducing girls to the sciences, maths and technology, and making them computer literate - disciplines vital to the modern world, but which tend to be shunned by girls. Mary Khanya, Swaziland's Ambassador to the United States, told IRIN: that they are interested in less in theory and more in how the programmes unfold to achieve results on the ground. She gave an exampleof what was achived throughl Strategy Education Centres which caters to girls who have dropped out of other schools due to pregnancy or other reasons in northern Swaziland. The computer classes offered have created so much interest that ... girls from other schools [in the area] also come to learn. Getting potential corporate partners interested in the lives of African children requires ever more sophisticated marketing, conference delegates noted. In Zambia, USAID produced a 13-minute video of the stories of Zambian street children, and their transformation through education, told from the child's point of view. Innovations based on real life experiences, rather than theory, are increasingly shaping education policy, delegates said. (Source: PLUSNEWS, 6 October, 2003).

Swaziland has the dubious distinction of having the second highest HIV prevalence rate in the world, and there are no signs that its epidemic is stabilising. According to last year’s antenatal survey, 38.6% of pregnant Swazi women are HIV positive. This is marinally lower than Botswana’s rate of 38.8%. Since its formation two years ago, the country’s National Emergency Response Committee on HIV/AIDS has been grappling with what can be done about the epidemic. It recently asked the University of Natal’s Health, Economics and AIDS Research Division (HEARD) to assist it to identify problems and policy gaps. According to HEARD’s Professor Alan Whiteside, the Swazi antenatal figures are reliable, with each positive result being subjected to a second test. In addition, the results are corroborated by a large survey of 4 183 mainly male workers at the Royal Swazi Sugar Corporation conducted last year which revealed an infection rate of 37.5%. What is unique about Swaziland is how uniformly bad the epidemic is. There is little difference between rural and urban areas, says Whiteside. According to Whiteside’s research, one of the key driving factors of the epidemic is the fact that many Swazi citizens are migrant workers, seeking jobs in South Africa. There is also great mobility between rural and urban areas. Whiteside notes that the country’s government has shown commitment to addressing the disease, being the first SADC country to mention HIV/AIDS in its development plans. However, it is contrained by lack of capacity, bureaucracy and innovative ideas. But it is hard to develop innovative ideas in the face of results from a large behavioural survey conducted this year which shows that Swazi people are highly knowledgeable about HIV/AIDS though this knowledge has not translated into desirable behaviour change.(Source: Kerry Cullinan, Health-e, 09-06-2003)