Africa and the fate of MDGs

The global community’s solutions to HIV/AIDS consistently fail to reflect the reality of women’s lives and the broader social-political forces that increase their risks. For most of Africa, HIV/AIDS prevention is more of a security and peace issue, not just reproductive health. It may have started as a reproductive health issue years back but that is not where it has remained as a big problem.

HIV/AIDS and war have a very symbiotic relationship that cannot be simply brushed aside. In former conflict countries like Angola, Mozambique, Liberia, Rwanda, Sierra Leone, and current conflict zones engulfed in political chaos like Congo, Northern Uganda, Darfur, Kenya, Zimbabwe, South Africa, Ethiopia, Eritrea, Somalia, Djibouti, Chad, Central African Republic and others, both armed men and civilians have become predators rather than defenders, unleashing sexual violence and terror and the people who have suffered greatly as deliberate targets for rape, defilement, torture, sexual slavery, trafficking, and forced marriages are the women and young girls. I wonder how much of ABC—abstinence, behavioural change and condom use applies in these situations. Yet we are happy to dream and to clap when an increase in Abstinence funds is announced. I stand to be convinced that in the recent Kenya violence, for instance, any one of the perpetrators and rapists used a condom. Obviously, for both the victims and victimizers, there was no abstinence and behavioural change did not apply either.

If an HIV/AIDS test can be carried out in Kenya now, I am certain it would reflect that the number of those infected is high among women, because women are not the ones who go out to rape, defile and possess forcefully.

While the ABC may be an effective method of preventing HIV/AIDS and other sexually-transmitted diseases or unwanted pregnancy, ABC only works under a huge assumption that situations of equally shared rights and conjugal responsibilities between men and women exist, circumstances where sexual consent between adults is possible and one can say no or in a moment of raging passion bank on a condom. The number that falls in this kind of strata is very small, given the harsh reality of vast, war torn Africa. But we have boxed ourselves into the ABC triangle we can hardly see how incongruous it stands out in most of African countries where politically engineered sexual violence is the order of the day. Countries that have been relatively stable over the years like Senegal, Mauritius, Ghana, and Botswana (if you do not count the mistreatment of the San people,) do not exceed 10 and Africa is comprised of 53 countries. This could mean that 98% of the HIV/AIDS money that is concentrated on ABC campaign is wasted money and so will not achieve the desired goal, reason being that more African countries have active violence going on, or have just come out of conflict while others are sitting on a conflict volcano about to erupt.

The 2007 AIDS epidemic update reports that in a number of African countries, behaviour change seems to be associated with a recent decline in HIV prevalence. The truth is that prevalence has declined in all countries where there has been some semblance of peace for the last ten years or so. The lesson is simple. Promote peace and you have reduced HIV. Have one day of active conflict and the HIV positive statistics will shoot up because of the sexual violence that comes with it. It’s a war package. The sobering question is whether African governments are committed to fighting HIV/AIDS via peace in the country or like most presidents and the first ladies they want cheap fame and will parade as HIV/AIDS crusaders by preaching abstinence and behavioural change.

We do not need the ABC campaign in most of current Africa. The latest addition towards combating HIV/AIDS is even more hilarious—circumcision. Allegedly, it can reduce HIV transmission by up to 60 percent. If we must rank, I think this is slightly better than Zuma’s bubble bath after sex with an HIV positive woman. But circumcision lowering HIV/AIDS risks in the face of conflict and regional insecurity when men are on rampage, I have less faith.

For want of humour, I would like to see cartoonists’ drawings of thousands of women about to be raped, stretching out their hands to the men who are about to rape them and asking: Are you circumcised? Have you a condom? Or, Will you be faithful to me? Can we abstain until further notice? The reality perhaps will sink in then that what we are fighting in Africa is not HIV/AIDS as a public health threat but misrule and bad governments.

The civil war in Sierra Leone alone created a population of nearly one million internally displaced people. The genocide in Rwanda saw about 500,000 Rwandan women displaced, raped, beaten and tortured. The violence did not end when the women arrived at the refugee camps. They reported that men walked into their huts at will and continually raped them. On their way to the latrines and to fetch water the women and girls were still getting raped. Self-appointed guards at the water taps and those giving out relief foods demanded sexual favors from the women. After some time, there was behavioural change in the other direction. Women became sexually active and resorted to more sexual partners in the camps in order to receive their portions of food and other basic needs. In Sudan, the ongoing civil war has created about four million internally displaced persons, while in Angola conflict has displaced 2.5 million people and 1.6 million people in the Democratic Republic of the Congo. Currently there is a massive refugee crisis in the Great Lakes region, not to mention other areas like the Horn of Africa, Central and West Africa, then Southern Africa. This large group does not seem to be the composition that is likely to benefit from the United States grand intervention that early this year agreed to triple its spending on combating HIV/AIDS in Africa by pledging $10 billion annually over the next five years. The U.N. estimates it will need more than $3 billion by 2010 for HIV prevention efforts in Africa, categorically ABC.

The malaria fight is even more subtle and therefore more deadly in defying global interventions. In my impressionable days I was part of an ecstatic team parading the slogan: Mosquito nets for all. I volunteered my time and a bit of money, got onto the truck, played some loud music for attention—a trick that all advertising companies and crusaders do, and hit the road. We went to a large village in south-western Uganda to distribute mosquito nets donated by the global fund. Within no time a crowd gathered. We spread the usual message, why the people must use the nets, we gave bits of life assurance after the net, and a brief background of our organisation’s saving mission statement. I did most of the crisp talking, then started dishing out the nets while chanting the slogan: Make Malaria History. If I must be honest, I gloried in the vain moment and shook hands with the people, sure to write a triumphant activity organization report afterwards. Reduced malaria, how nice! All the nets were taken, especially by the women, some taking more than they needed but explaining that they belonged to large households. We wanted entire families to be saved so we indulged them. Before I could get away from the crusade scene, one woman tapped on my arm and asked a puzzling question:

“Madam, you have said we hang the nets above our beds but we don’t have beds.”

In our passionate campaign we had overlooked such a scenario. I swallowed saliva and said the silliest statement that walked out of my mouth: “Wrap the net around yourself in the night when you go to sleep.”

The woman was indefatigable, still holding onto my hand she asked:

“How will I make love with my husband?”

Realising that the situation was no longer under control, I tried an escape route:

“Now I must go but in a few days I’ll get back to you on that one.”

Truth is I’ve never gotten back to her on that one, but the scene gets back to me all the time. Shortly after the crusade, I came to learn about a unique innovation that beats necessity: Many women who took the nets sewed them up and used them as wedding gowns. A brief background into this revealed that their men were refusing to set up wedding dates on account that they did not have money to buy for their women wedding gowns. The women toyed with the problem and saw their answer in the shape of mosquito nets. So they provided the gowns, and even made matching dresses for maids and flower girls. The next thing that happened, both bride and groom were ready for the marriage ceremony. The battle against mosquitoes was lost. I gave up volunteering for health causes, realizing that the problems we aimed to solve were not the problems we ought to solve, but tips of underlying basic and intricate problems. Now I spend my days writing about these failed missions and trying to figure out a more creative way of engaging women, men and children in the here and now.

I change channels and turn the pages when there is news of malaria campaigns, to be followed by massive distribution of mosquito nets. Global fund investments support of bed nets distributed continues to be doubled, reporting progress with a cumulative total of 59 million insecticide-treated bed nets delivered to families at risk of contracting malaria. In mid 2007, 30 million nets were distributed. In December 2007, 46 million nets were distributed and mid 2008, 59 million. Dreaming wildly, the Global Fund is helping to finance 109 million bed nets to protect families from malaria, thus becoming the largest financier of insecticide-treated bed nets in the world. I smile a sad smile because I know there will be many weddings right after these distributions. The gospel hasn’t really changed in spite of the ineffectiveness, and the new science research that has shown that the ingenious mosquito has found a way to stay resistant to such treated nets.

There is too much hype about the millennium development goals, and I wonder why social development nationals and governments do not engage their locals one-on-one, so to speak, to work hand in hand and solve challenges contextually, communally, other than wearing blinds that a global umbrella tool kit will do.

Now I will not even go into the goal of eradicating extreme poverty and hunger, or achieving universal primary education, though I could write a thing or two about value system. Most people that we think are poor in Africa simply operate under a different value system. It takes active involvement and participation to change someone’s value system. I have met parents who can afford school fees but choose not to send their children to school because they are holding on to their own cultural, value system. Others have sent their children to schools miles away not because they value education but because of the free lunch that’s given at the end of the lessons. Local practitioners know this but the UN cohorts are between the dreaming and the coming true, enthusiastically setting targets for achieving the goals, forgetting the here and now.

It is the desire for context-specific, locally designed, creative solutions that make me think of Mo Ibrahim African leadership prize. Ibrahim came under intense criticism for acknowledging Mozambique ex-president Joachim Chissano’s role in leading Mozambique from conflict to peace and democracy, by awarding him the $5 million prize spread over the course of ten years, plus $200,000 per annum until the end of his life on Earth, subsequently beating the $1.3m Nobel Peace Prize. Truly grand! And more grand was and is Ibrahim’s belief that Africa can. Chissano’s decision not to seek a third, presidential term when he could have clearly set him apart as a wise leader committed to democratic maturity, peace, and clean leadership. In the end it is not Chissano that looked more important and dignified as a personality, but that peaceful and democratic states were more desired, and an individual like Mo Ibrahim was ready to invest in such a, yes, dream. Conventional approaches would have preferred Ibrahim to start with his home country, Sudan. Maybe build a school, a hospital, but that’s not how he sees things and he’s absolutely right. In this continent’s struggles, Africa is home, not a country.

Think of the present presidents and all ex-presidents who are still genuinely working towards changing Africa’s harsh realities. Nelson Mandela aside, ex-president Chissano is the only one so far who has been consistent about building lasting peace and promoting secure environments within the democratic field. If found, good governance seems to be the missing jigsaw puzzle that would hold every other thing in place, that would make the ABC work since there would be no more war, sexual violence and other evils. All the children then would go to school, safe and secure. There would be national development and available social services.

It is against this backdrop of peace and what it can achieve for the people that glancing at the Zimbabwe situation—caught between a rock and a hard place—we should consciously choose Chissano to take on Zimbabwe through the difficult interval, the here and now. The opposition leader Morgan Tsvangirai is against the re-run, predicting further loss of lives. President Robert Mugabe is unflinching; he wants to stay the president however scandalous and illegitimate. Chissano has his own flaws but by far he seems the only right person who would stay neutral if he became the president and has no personal motives for wanting to be president of Zimbabwe anyway. But the conditions allow and necessitate that he participates and becomes the one to usher in a new era. And pray let us not start that debate on whether Chissano is Zimbabwean or not, if we go that route, what do you think the African Union is for? Right now, we are no longer watching two elephants tearing Zimbabwe apart but our eyes are on SADC and the African Union. They have the mandate to redeem the Africans living in Zimbabwe or to betray them. I think in the pan-African spirit, a former honoured African head of state who stepped down with dignity in his country should be called upon in an emergency to lead in another country if members of the CCC—critical condition country—are caught between a boulder and a mountain.

The only challenge I foresee is that there are not many presidents, later on ex-presidents with an honest track record, competent and transformative enough to lead Africa in the here and now.

*Mildred K Barya is Writer-in-Residence at TrustAfrica (www.trustafrica.org)

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