Reflections on the research trip

As I wasn’t able to update the blog regularly, I’ve decided to write up
some of the notes from the trip.

Through my research I found out about attitudes of local Swazi people
towards HIV and AIDS, including some of the myths related to HIV in small
rural communities. I interviewed Swazi healers, known as ‘Sangoma’s’, to
find out about the role of traditional healing practices, as well as
meeting with young people to understand their attitudes towards the
levirate custom, polygamy and the tradition of men owning women.

Many women explained how, when they tested positive when pregnant, their
husbands or partners did not allow them to receive the necessary treatment
that prevents transmission of the virus to the baby. I found this
shocking, and as the women talked further I began to understand that there
are many issues behind this, not least the high level of stigma and
denial that surrounds HIV and AIDS.

The most positive and uplifting discussions I had were with these women
who, it seemed, had been on a long journey coming to terms with living
positively and who had managed to protect some, if not all of their
children from HIV, even if they had tested HIV positive themselves.
Through healthy diet, exercise and antiretroviral treatment they could
care for their children and live for up to another 20 years.

King Mswati III, Africa’s only absolute monarch, declared AIDS a national
disaster in 1999. Free condoms are available and HIV testing is encouraged
even in the most remote rural areas, but many men still refuse to use
condoms even when they know they are HIV positive and the percentage of
women that test is far greater than men. As well as going out into the
countryside with health workers who were running programmes preventing
mother-to-child transmission of HIV and antiretroviral therapy programmes,
I learned about projects promoting abstinence and male circumcision, which
reduces the infection rate.

The problems HIV/AIDS has caused for children are overwhelming. Around 15%
of children are orphans (only 22% of children currently grow up in
families with both parents), there has been a huge increase in child abuse
and prostitution, especially with young girls who are particularly
vulnerable and need money for food, clothing, school fees, accommodation,
as well as supporting their siblings. With a gatekeeper I was able to
visit child-headed families where both parents had been lost to AIDS and
the eldest child, having had to nurse their dying parents, now had to look
after the younger children, getting them up, cooking, cleaning, hand
washing clothes before walking to school and working through the school
holidays to earn money for food, but they were unable to earn enough and
often went hungry.

I was also able to interview researchers, health practitioners and aid and
development workers who have conducted studies on the reasons behind the
high prevalence of HIV and AIDS in Swaziland. I was constantly struck by
the enormity of the country’s problems and the lack of answers, the clash
between traditional cultural beliefs and the forceful push from the young
for change.

The main drivers behind the spread of the epidemic are outlined in ‘The
Second National Multisectoral HIV and AIDS Strategic Plan 2006-2008’ as
being multiple concurrent sexual partners, inadequate public awareness of
the epidemic, decline of moral values, a lack of seriousness in dealing
with the epidemic, secrecy and denial of HIV infection, inter-generational
sex, cultural beliefs and practices with negative implications, high
mobility of the population, abuse of power by men in sexual relationships,
sexually transmitted infections, poverty, low condom use, early sex,
population momentum, alcohol and drug abuse.

Unlike many other countries the main high prevalence group testing HIV
positive in Swaziland is not in sex workers, homosexuals and intravenous
drug users, but married couples.

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