Here is a great editorial about the effects of HIV/AIDS in Africa.
Take care,
Celia
On 20 Nov 2002, [log in to unmask] wrote:
> Hey!
>
> This is an editorial from the NYTimes yesterday. This past Monday I was
at a
>
> guest lecture where Mr. De Waal spoke in quite sobering terms on the
looming
> disaster when famine hits Africa in the context of AIDS.
> Yes, things can get worse. We have lots of work to do.
>
> peace,
> Ricky Y. Choi
> HHR Coordinator
>
>
> November 19, 2002
>
> What AIDS Means in a Famine
>
> By ALEX DE WAAL
>
> DDIS ABABA, Ethiopia
> Just as H.I.V. destroys the body's immune system, the epidemic of H.I.V.
and
> AIDS has disabled the body politic. As a result of H.I.V., the worst-hit
> African countries have undergone a social breakdown that is now reaching
a
> new
> level: African societies' capacity to resist famine is fast eroding.
Hunger
> and
> disease have begun reinforcing each other. As daunting as the prospect
is, we
>
> will have to fight them together, or we will succeed against neither.
>
> About 29 million Africans are infected with H.I.V. The epidemic is spread
by
> heterosexual transmission almost entirely. Only 30,000 of these people
are
> receiving
> antiretroviral treatment. Between three million and four million people
are
> dying each year from AIDS-related diseases. Twenty percent of adults in
South
>
> Africa live with H.I.V.; the figure is higher still in Botswana, where
life
> expectancy has plunged below 40 years.
>
> How do such realities relate to famine? Traditional agrarian societies in
> Africa were well adapted to the threat of drought. Food shortage was like
a
> familiar virus,
> unpleasant and painful but one to which most people had resistance. For
> example, the victims of famine were almost exclusively young children and
the
>
> elderly. Young adults rarely died - and women survived better than men.
> Society's core was preserved, and it could recover. Rural Africans were
> experts
> at surviving famine. Women knew exactly what wild grains, roots and
berries
> could be eaten as famine foods when there was no maize. Families
scattered
> their members over a wide area and called on distant relations for help
when
> times got hard.
>
> These coping skills meant that rural Africa was forgiving of the
shortcomings
>
> of international relief programs. Typically, calls by the United Nations
for
> food donations
> fall short of their goal by half or more. Yet the inhabitants of, say,
> Mozambique or Sudan have still pulled through.
>
> This is changing. We are facing a new variant of famine: in societies
hurt by
>
> AIDS, famine is more deadly and less susceptible to existing treatments.
The
> reason is that AIDS attacks exactly those capacities that enable people
to
> resist famine.
>
> AIDS kills young adults, especially women - the people whose labor is
most
> needed. When the rains come, people must work 16 hours a day planting and
> weeding
> the crop. If that critical period is missed, the family will go hungry.
In a
> community depleted by AIDS, each working adult must produce more to feed
the
> same number of dependents - not just children but sick adults, too.
>
> The burden of care for those sick with AIDS can cripple a family. Many
> employers - private and public - have withdrawn benefits. Town dwellers
who
> fall sick go
> home to the village to pass their final months, to die and be buried.
> Children
> orphaned by AIDS are sent to the village to be cared for. There is a
> prevailing
> myth that the African extended family will cope with this double burden
of
> care. We are learning the hard way that it cannot.
>
> The drop in adult life expectancy also has implications that we are only
just
>
> beginning to appreciate. The normal generational cycle means that assets
like
>
> land and
> cattle are accumulated and handed down by the older generation.
Grandparents
> can assist with child care; older women can pass on a lifetime's
experience
> of
> gathering and preparing wild grains and fruits to their daughters. Today
all
> this is interrupted. Young people are inheriting debts and are not
learning
> essential skills. How can a young woman, looking after six children, have
the
>
> experience and skill of her mother or grandmother in cultivating her
field,
> collecting wild fruits and planning for survival through a tough year?
And
> can
> she even make any plans on the premise that things will return to normal
some
>
> day?
>
> Finally, the first response of any adult faced with a harvest failure is
to
> tighten her belt. Relief workers in Africa have become so used to this
> physiological resilience that they ignore adults' nutritional needs and
just
> focus on children. But adult hunger is no longer a passing difficulty. A
> person
> living with H.I.V. needs better nutrition - more calories and especially
more
>
> protein - to stay healthy. Malnutrition accelerates the progression to
AIDS.
>
> As their livelihoods collapse, their family networks fold and their
coping
> strategies vanish, millions of young women are turning to what is
> called "survival sex" to feed their children. The consequences for H.I.V.
> transmission do not need to be spelled out.
>
> In short, H.I.V. is imperiling the ability of African societies to
reproduce
> themselves. Even when the rains come we will not see a return to normalcy
but
>
> merely a breathing space. And we will be forced to appreciate just how
> different this crisis is.
>
> Some senior United Nations leaders, notably Kofi Annan, the secretary
> general,
> have recognized the scale and gravity of the AIDS cataclysm and its link
to
> famine. But the policy tools we have are blunt, fashioned for a different
> kind
> of crisis. We can't just ship in food. Food assistance and scaled-up
> antiretroviral treatment must go hand in hand. We need imaginative and
large-
> scale responses to the burden of care: how to support the millions of
people
> who are looking after dependent children (many of them orphans) and
people
> with
> AIDS? We need to re-examine farming systems to put more money into
farmers'
> hands and more protein on their tables. Above all, we need to restore a
sense
>
> of the future to a generation facing an appalling crisis, to help unlock
> their
> energies in search of solutions.
>
> Alex de Waal is director of Justice Africa and an adviser to the United
> Nations
> Economic Commission for Africa and Unicef.
>
>
> Copyright The New York Times Company | Permissions | Privacy Policy
>
>
> ************************************************
> Ricky Y. Choi
> Harvard Sch of Public Health -MPH Candidate
> Medical Univ of South Carolina, College of Medicine -MS IV
> American Med Students Assoc (AMSA) -Health and Human Rights Nat'l
Coordinator
>
> [log in to unmask]
> [log in to unmask]
> 843 324 2146
> ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
> "It doesn't have to be this way." ryc
> "You must be the change that you want to see." M Gandhi
>
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