HIV-AIDS orphans face life alone in Swaziland

HIV/AIDS in Swaziland

Introduction 

Did you know that while there are more than 36 million people suffering from AIDS worldwide, more than two thirds of them occur in sub-Saharan Africa? What an astounding factt! In knowing this, statistics have shown that the small country of Swaziland, with just over one million people, has the highest rates of about 26%. AIDS, Acquired immune deficiency syndrome is a disease caused by the virus, HIV (Human Immunodeficiency Virus). It attacks the immune system, resulting in increased vulnerability of the body to opportunistic infections.  As a result of this, millions of children have become orphans due to their parents’ deaths from AIDS. AIDS is prominent in many of the rural areas of Swaziland, as these are the poverty struck areas where health and transport services are not available or accessible. It is extremely important to note that their population statistics, including their high birth and death rates account for the appalling effects of the disease, including lower life expectancy and population growth and higher infant mortality along with death rates. Therefore, there is a crucial factor involved, which is understanding the relationship between women and AIDS and how they both influence each other.

Statistical Data on HIV/AIDS in Swaziland

Swaziland is hard hit by the HIV/AIDS pandemic. Various forms of intervention strategies have been adopted by the government as well as civil society to combat the spread of the pandemic and deal with its consequences. However, little change in the trajectory of HIV prevalence has been observed thus far. The data showed below is an attempt to illustrate statistical analysis of the level of the pandemic as of 2012.

Figure 1 UNAIDS, Report on the global HIV/AIDS epidemic, Geneva, 2012

In figure 1 the Swazi population pyramid shown is typical of an Africa population. The reasons for the decrease in 0-4 year olds are not known. However if this pattern continues, AIDS mortality and decreasing fertility will be implicated. The large number of people under the age of 25, clearly shown on the graph, means that HIV spread will be maintained in the absence of effective interventions. 

Figure 2 . AIDS Analysis, (Swaziland Country Focus), Vol. 13, No 1

Figure 2, the release of the 2012 survey data puts Swaziland in the unenviable position of having the second highest national ANC HIV prevalence in the world. Botswana is first, but only just, with HIV prevalence of 38.8 %.

Figure 3 Ministry of Housing and Urban Development (Burrow Binnie/Euroconsult), Land

There is also little difference in HIV prevalence between districts, whether it be rural or urban: Hhohho has the lowest level at 36.6%; and Manzini the highest at 41.2%. These are the richer and more urbanized districts while the poorer and more rural districts of Lubombo and Shiselweni have prevalence rates of 38.5 and 37.9% respectively

Figure 4 National Emergency Response Committee on HIV/AIDS (NERCHA) and United Nations Programme on HIV/AIDS (UNAIDS)

Out-of-school youth’s sexual debut was at an older age. It is also striking that these people’s partners have been uniformly older than was the case for those in school. This is significant because it may indicate exploitative relationships. The relationship between older men and younger women has been identified as crucial in Swaziland.

Figure 5 Family Life Association of Swaziland. In and out of school youth family health needs

And sexual behaviors, attitudes and family planning practices – Manzoni and

Lubombo.2012

This data shows the percentage having sexual intercourse by age group. As shown there is a high level of girls having sexual intercourse at an early age and this may influence the structure of the population pyramid shown as the likelihood of HIV spreading throughout age group increases thus increasing the number of future age groups and influencing the shape of the population pyramid 

Figure 6 Family Life Association of Swaziland. In and out of school youth family health needs

and sexual behaviours, attitudes and family planning practices – Manzini and

Lubombo.2012

Reason behind the spread of the Epidemic

From the statistic stated in the intro, Swaziland without a doubt has the highest percentage of persons affected by HIV/AIDS. If you look closely you might have seen that the HIV statistic for women in Swaziland, the numbers seem to be increasing over the years. This small Southern African country has become over run by this epidemic. The reason for this is uncertain to many. But...there has been a theory put forward that the main reason for the high number of HIV/AIDs cases is the Swazis’ culture encourages the spread of the disease.

"Swazis are very traditional people, and their sexual behaviour is inbred and totally against safe sexual practices, like condom use and monogamous relationships, that limit the spread of HIV," Thandi Mngomezulu, an HIV testing counsellor in Manzini. Further research showed that the status of women is low is Swaziland so men usually dictate what is said and done. The men refrain from using condoms and this just contributes to the spread disease. With the status of women being insignificant, their culture of polygamy (more than one spouse) is allowed. A man having multiple female partners and not practicing safe sex is what causes the increase of the epidemic, especially among women. Women usually become impregnated and due to inaccessible or unavailable prenatal care the disease is usually passed on from mother to child, increase the number of HIV/AIDS cases. In the Swazi’s society male births a preferred as they can carry on he can carry on th family name. When females are born, there is a concerted effort to make more offspring until a male is produced. This also leads to the spread of the disease from male partner to female partner to children and it also result in their high birth rate.

Government Response to HIV/AIDS in Swaziland

They have been in an ongoing battle since the first case was reported in 1987. Due to this virtually uncontrollable rate of infected persons, many ask the question of what is the Government of this poor nation and to some extent the rest of the world doing to address this calamity.

Government Response:

In 2012 the government of Swaziland along with the support of the UNAIDS organisation set out specific targets to fight the growing problem of HIV/AIDS.  Their first target announced was to reduce the sexual transmission of HIV by 50% by the year 2015. This can only be done by education of the population. The second task set out was to reduce the transmission of HIV among people who inject drugs by 50%by 2015. The third target was to eliminate mother to child transmission of HIV by 2015and to reduce the amount of AIDS related maternal deaths.  Lastly the government introduced polices where the government will allow treatment, care and support facilities to be more available throughout the country.

But with all of these plans by the government, there are also many challenges, which will stifle the plans of a country. Because of the high amount of persons living with the disease there is also limited labour, and when there is employment the workers suffer from poor working conditions.  Additionally the country’s economy cannot support its plans on its own therefore many external private organisations, the World Health Organisation (WHO) and UNAIDS balance off the funding through the global Fund to fight AIDS.

An MSF community testing counsellor explaining HIV/AID to a person in a village in Swaziland. (source: MSF.org.uk)

At Phocweni Clinic, a military health center that provides HIV testing and counselling services in Swaziland’s capital city of Mbabane, a pharmacy provides drugs for patients infected with HIV and tuberculosis. (source: stripes.com)