AIDS disrupts rural Africa
International organizations and researchers must do more for the survivors, according to participants at the congress on AIDS, Livelihood and Social Change in Africa
An estimated 10 million Africans have died from AIDS. An additional 25 million men and women are HIV positive. Tanzania, Zimbabwe and Botswana are hardest hit. Pregnant women in Zimbabwe are routinely tested and the figures show that 30 to 50% of the rural population is infected
Behind the statistics there are harrowing stories. Tanzanian researcher Gabriel Rugalema (35) followed some 50 children through their primary education. There are only four of them left, he recounted at the conference AIDS, Livelihood and Social Change in Africa, held 15 - 16 April in Wageningen. Rugalema first became aware of the drastic consequences of AIDS about 10 years ago. Since then he has been trying to impress upon researchers, policy makers and international organisations that AIDS is not only a medical but above all a social problem. AIDS and poverty go hand in hand. He gave the example of a sixteen-year old orphan who had become a prostitute. I'd rather die of AIDS in 15 years' time than die now of hunger, was her way of putting the dangerous profession she had chosen into perspective
The AIDS epidemic is seriously endangering food security in rural areas. On average, an AIDS patient in Tanzania is sick for between a year and eighteen months. During this period, the equivalent of one member of the family will be fully occupied looking after the sick person, whether at home or in hospital. This means the loss of two people's labour power. A household hit by AIDS also becomes more impoverished because of the costs of medical care and the funeral. Livestock and other valuable goods may have to be sold and children are taken out of school. Instead of cultivating commercial crops such as coffee and bananas which are labour intensive and require pesticides and fertilizers, families are returning to more traditional crops such as sweet potatoes, taro, cassava, sorghum and finger millet. But Rugalema is not convinced that these adjustments really mean that households are coping with AIDS. These households have no cash to pay for school fees or medicines. That's not coping.
The survivors of the epidemic are mainly older women and children. The countryside is becoming feminized. Rural Shona women in Zimbabwe traditionally had no direct access to land. A married woman's access to land depends on the consent of her husband, tells American researcher Sam Page. Paradoxically, as far as women are concerned, it is AIDS widows who now have the best access to land: they are being allowed to continue farming on their late husbands' land because men are becoming reluctant to follow local tradition and marry their brothers' wives. However, Shona women are not used to making important management decisions. This means they are more likely to make mistakes. Page encountered the widow Theodora, who had sunk her last money in the purchase of two cows. These animals died and now Theodora doesn't even have enough money to buy a chicken
The fact that other aspects of society are also being disrupted by AIDS makes it even more difficult to help AIDS victims in rural areas. Not a lot can be expected of the extension services and the educational sector, warned UN employee Desmond Cohen. These groups are also severely hit by AIDS. Cohen believes that not enough is yet known about the wider social consequences of AIDS, for example for the economy. He cites Botswana as an example of a country known for its excellent development planning. Every sector plan is compiled as though AIDS didn't exist. Usually a paragraph is tacked on at the end, mentioning the effect AIDS might have on a particular plan.
Research and extension work should concentrate on the AIDS survivors. This will require a change of direction: that much the conference participants agreed upon. There are many questions to be answered. What are the legal problems that AIDS widows face in countries where they are not traditionally livestock or land owners? What can West Africa, not yet as badly hit, learn from the experiences of countries like Tanzania and Zimbabwe? How can the experiences with Farmers' Field Schools in Asia be made suitable for widows and orphans in Africa? The participants want to start by exchanging information. A discussion about whether or not to set up a website led to a reaction of frustration from one African participant. Let's talk about how we can get hold of medicines there, he responded animatedly. Although this plea met with applause it changed little in the final discussion. Iris Shiripenda of the Centre of Women's Studies in Nijmegen understands the participants' frustrations. She believes Western researchers should do more action oriented research, combining research and help. The local population should receive something directly in return for the information they give. For example, researchers could help in obtaining access to medicine. Researchers should not just take and take. Lianne Kersbergen