A GRASS-ROOTS LOOK AT HIV/AIDS IN BOTSWANA

UNCLAS SECTION 01 OF 02 GABORONE 003514 E.O. 12958: N/A TAGS: KHIV EAID SOCI MASS PHUM BBG BC SUBJECT: A GRASS-ROOTS LOOK AT HIV/AIDS IN BOTSWANA REF: GABORONE 3255 INTRODUCTION -------------- ¶1. DURING OUR RECENT TRAVELS UPCOUNTRY, THE AMBASSADOR AND EMBASSY STAFF LOOKED AT COMMUNITY-BASED ACTIVITIES IN THE FIGHT AGAINST HIV/AIDS AND INTERAGENCY USG SUPPORT FOR THOSE EFFORTS. IT WAS A SOBERING EXPERIENCE THAT EMPHASIZED THE DEBILITATING SOCIAL EFFECTS OF THE DISEASE. SELEBI-PHIKWE: "NUMBER ONE IN THE COUNTRY, NUMBER ONE IN THE WORLD"; THE STIGMA OF HIV IS "GENOCIDE" -------------- ¶2. ON OCTOBER 19, WE ATTENDED THE OFFICIAL OPENING IN SELEBI-PHIKWE OF ANOTHER TEBELOPELE VOLUNTARY COUNSELING AND TESTING CENTER. AS PART OF OUR INTERAGENCY EFFORT, THE IBB/VOA STATION MANAGER INITIATED NEGOTIATIONS WITH LOCAL AUTHORITIES FOR THE PLOT OF LAND, THE OFFICE OF DEFENSE COOPERATION BUILT THE STRUCTURE, AND THE CENTERS FOR DISEASE CONTROL AND PREVENTION PROVIDED EQUIPMENT AND STAFF. THE OFFICIAL OPENING, WHICH ATTRACTED AROUND 200 PEOPLE, WAS AN UPBEAT EVENT WITH A SERIOUS THEME. IT INCLUDED A TENT AND LARGE "KNOW YOUR STATUS" SIGNS TO ATTRACT ATTENTION ON THE TOWN'S MAIN STREET; A SKIT IN SETSWANA ON HIV/AIDS; AND SPEECHES BY LOCAL OFFICIALS, THE AMBASSADOR AND THE MINISTER OF HEALTH. ¶3. IN AN IMPASSIONED SPEECH ALTERNATING BETWEEN ENGLISH AND SETSWANA, MINISTER OF HEALTH JOY PHUMAPHI USED A PHRASE WE HAD NOT PREVIOUSLY HEARD FROM GOB LEADERS. SHE SAID THE STIGMA ASSOCIATED WITH HIV/AIDS IS THE WORST CRIME THAT BATSWANA HAVE EVER COMMITTED AGAINST THEMSELVES AND SHE TERMED IT "GENOCIDE." SHE ALSO STRESSED THE POINT THAT A LEGAL DOCUMENT OF MARRIAGE DOES NOT PROVIDE ANY PROTECTION AGAINST HIV AND URGED PEOPLE TO BE TESTED PRIOR TO MARRIAGE. (SHE HAS TOLD US IN THE PAST THAT IN BOTSWANA, WHEN ONE PERSON IS INFECTED, THE SPOUSE IS GENERALLY ALSO INFECTED.) ¶4. IN HIS CLOSING REMARKS, THE TOWN CLERK DERISIVELY PROCLAIMED SELEBI-PHIKWE AS "NUMBER ONE IN THE COUNTRY, NUMBER ONE IN THE WORLD" IN HIV INFECTION. HE NOTED THAT BOTSWANA LEADS THE WORLD IN HIV INFECTION RATES AND WITHIN THE COUNTRY SELEBI-PHIKWE HAD TAKEN THE TOP SPOT FROM FRANCISTOWN. HE CITED THE MOST RECENT ESTIMATES FROM THE DECEMBER 2000 HIV SURVEY FOR BOTSWANA (FUNDED IN PART BY CDC) ESTIMATING THAT 45.7 PERCENT OF ADULTS AGED 15-49 IN THE TOWN ARE HIV POSITIVE. (SEE REFTEL FOR A FULLER SUMMARY OF THAT SURVEY.) THE CLERK ALSO DESCRIBED THE HUMAN IMPACT OF THE TOLL: THE COUNCIL CARES FOR 445 ORPHANED CHILDREN WHO ARE SCATTERED IN FOSTER HOMES AROUND TOWN (POPULATION 50,000). FRANCISTOWN: HELPING CHILD-HEADED HOUSEHOLDS WHERE PARENTS HAVE DIED OF AIDS; OTHER VULNERABLE CHILDREN -------------- -------------- ¶5. IN FRANCISTOWN THAT EVENING, MINISTER PHUMAPHI (WHOSE PARLIAMENTARY DISTRICT IS FRANCISTOWN EAST AND WHOSE HUSBAND IS A PROMINENT ATTORNEY) HOSTED THE LAUNCHING OF A TRUST AIMED AT ASSISTING (THROUGH PROVISION OF SHELTER, TRAINING, ETC.) THE LIVES OF DISADVANTAGED MEMBERS OF THE COMMUNITY (INCLUDING THE NEEDY, HOMELESS AND DESTITUTE ORPHANS). THE BASIC HOUSE TO BE PROVIDED TO THOSE IN NEED WILL CONSIST OF ONE BEDROOM, ONE KITCHENETTE AND ONE BATHROOM BUILT ON A SLAB FOR A TWO-ROOM HOUSE. MANY OF THE COMMUNITY LEADERS OF FRANCISTOWN (POPULATION 84,000) WERE IN ATTENDANCE AND THE MINISTER OF LOCAL GOVERNMENT GAVE THE KEYNOTE SPEECH. ¶6. PHUMAPHI TOLD THE AMBASSADOR THAT MUCH OF THE WORK OF THE TRUST WILL BE AIMED AT CHILD-HEADED HOUSEHOLDS, WHERE CHILDREN AS YOUNG AS 14 ARE CARING FOR THEIR YOUNGER SIBLINGS AFTER THE DEATH OR INCAPACITATION OF THEIR PARENTS DUE TO AIDS. OTHER HOUSEHOLDS TO BE ASSISTED INCLUDE THOSE IN WHICH BOTH PARENTS HAVE DIED AND THE AGING GRANDPARENTS ARE HAVING DIFFICULTIES COPING WITH CHILD-CARING RESPONSIBILITIES. ACCORDING TO PHUMAPHI, THE PERFORMANCE OF CHILDREN AT SCHOOL TENDS TO DECLINE IN THE LAST YEARS PRIOR TO THE DEATH OF A PARENT AS THE CHILD SUFFERS FROM STRESS AND ADDITIONAL DUTIES AT HOME. THE AMBASSADOR EXPRESSED SUPPORT FOR HER EFFORTS AND PROVIDED AN APPLICATION FORM FOR SELF-HELP PROGRAM FUNDING. ¶7. ON OCTOBER 20, THE SHINING STARS OF FRANCISTOWN'S MONARCH COMMUNITY OFFICIALLY OPENED THEIR NEW FACILITIES PAID FOR BY ODC AND THE SELF-HELP PROGRAM. MINISTER PHUMAPHI AND THE AMBASSADOR WERE KEYNOTE SPEAKERS. SHINING STARS IS A COMMUNITY OUTREACH PROGRAM, ORGANIZED UNDER TRUSTEESHIP OF THE TSHIRELETSO AIDS AWARENESS GROUP, BENEFITING 275 VULNERABLE CHILDREN AGED 2 - 18. THESE INCLUDE THOSE WHO ARE DESTITUTE, HAVE ILL PARENTS, OR ARE ILL THEMSELVES. THE ORGANIZATION DOES NOT LIMIT ITSELF TO "AIDS ORPHANS," AS AIDS CARRIES A STIGMA THAT IS AUTOMATICALLY TRANSFERRED FROM PARENT TO CHILD. CHILDREN ENGAGE IN LIFE SKILLS, ACADEMIC AND SPORTS ACTIVITIES AND ARE EDUCATED ABOUT HIV ("SO THEY CAN STAY BEHIND WHEN EVERYBODY ELSE HAS GONE," ACCORDING TO THE SHINING STARS DIRECTOR). ALL WORK IS PERFORMED BY VOLUNTEERS, AS THERE ARE NO PAID STAFF. ONE OF THE TASKS FOR ADULT SPONSORS IS TO CARE FOR PARENTS SICK WITH AIDS SO THAT THEIR CHILDREN CAN ATTEND SCHOOL. ¶8. THE ODC SUPPORT, PROVIDED THROUGH DOD'S HUMANITARIAN ASSISTANCE PROGRAM, INCLUDES TWO BUILDINGS, A CLASSROOM/LIBRARY AND A KITCHEN/COMMON ROOM/REST ROOM FACILITY. THE AMBASSADOR'S SELF-HELP FUND HAS PROVIDED SHINING STARS WITH EDUCATIONAL EQUIPMENT, FURNITURE AND A COMMERCIAL OVEN FOR PRODUCING BREAD FOR SALE TO THE COMMUNITY. PROCEEDS FROM THE SALE OF BREAD WILL BE USED TO COVER ORPHAN-CARE OPERATING EXPENSES. IT IS HOPED THAT THIS WILL REDUCE SHINING STARS' DEPENDENCE ON LOCAL DONORS AS WELL AS GIVE ORPHAN BENEFICIARIES A SENSE OF BEING ABLE TO CONTRIBUTE BACK TO THE COMMUNITY. ¶9. THE DIRECTOR HAS WORKED VERY HARD AND IS DOING A COMMENDABLE JOB, BUT SHE STILL DOES NOT RECEIVE ENOUGH COMMUNITY SUPPORT FOR EVERYDAY EXPENSES: THE ELECTRIC COMPANY HAD THREATENED TO CUT OFF POWER ON THE DAY PRECEDING THE EVENT. THIS IS THE SAME ORGANIZATION WHERE THE CHILDREN, DURING OUR VISIT LAST YEAR, SERENADED US WITH A SONG CARRYING THE HAUNTING REFRAIN, "MY MOTHER DIED BEFORE I MET HER." COMMENT -------------- ¶10. THE TWO-DAY TRIP PROVIDED US WITH ANOTHER GLIMPSE AT THE PERVASIVE IMPACT HIV/AIDS IS HAVING ON BOTSWANA. NOT ONLY ARE MANY ADULTS ALREADY INFECTED, INCLUDING NEARLY ONE OUT OF TWO PEOPLE IN THEIR 20S, BUT LARGE NUMBERS OF CHILDREN ARE SUFFERING EITHER BECAUSE THEY WERE BORN HIV POSITIVE OR BECAUSE THEIR RELATIVES ARE DYING OF AIDS. AMONG THE MANY USG PROGRAMS IN BOTSWANA RELATED TO HIV/AIDS, WE WILL CONTINUE TO SUPPORT PROGRAMS AIMED AT ASSISTING SUCH NEEDY CASES. LANGE