In
the neighbourhood of Mabopane, a suburb of the South African
capital Pretoria, she is known as “Auntie Elizabeth”.
This 37-year-old woman single-handedly looks after the five
children left behind by her sister – who died of AIDS
in 2003. One of the children is living with HIV.
Elizabeth is alone in having to care for the five children who
would otherwise have been left to fend for themselves. The family
is crammed into a garage, for lack of anywhere better to live.
However the most painful difficulty is that family lives in
isolation, scorned by the neighbours who stop the youngsters
from playing with their own children. They feel it’s “too
risky”.
Auntie Elizabeth’s situation is by no means unusual –
and that’s just the problem. There are thousands of children
living without an adult, deprived of all family contact when
the extended family is wiped out by AIDS. The older children
are often forced to interrupt their studies in order to look
after the younger ones. Girls are particularly vulnerable. They
are easy prey for those who try to buy their virginity in order
to cure themselves of AIDS – or so they mistakenly think.
This is what certain charlatans posing as healers have tragically
promised them – for a fee.
This is the reality of HIV. Southern Africa, where more than
12 million people are living with HIV - of whom 860,000 are
children under the age of 14 - has been hit particularly hard
by the pandemic. The number of children orphaned by AIDS in
this region alone is expected to double by 2010.
While southern Africa is the hardest hit region, the rest of
the African continent is also seriously affected. Very often
there are associated serious breaches of basic human rights.
This includes violence against women: not only the rape of women
and girls in situations of armed conflict but also sexual and
gender based violence that is highly prevalent in most domestic
and community settings.
But Africa does not have a monopoly on suffering when it comes
to HIV. The vulnerability of women and girls can be just as
striking in other regions, a reflection of socio-cultural factors
as well as the pervasive inequality of the sexes. This is so,
even in well-off parts of the world such as in Latin America
and the Caribbean where, over past decades, women have become
much better educated and economically active, but gender inequalities
persist, and the HIV epidemic has an increasingly feminine face.
The same is true for Asia and Europe – particularly eastern
Europe. Ignorance remains one of the driving forces behind infection.
Many young people in the former Soviet republics do not perceive
HIV as an issue that concerns them. Meanwhile, each day women
are giving birth to children who are HIV-positive.
In recent years, progress has been made in making a wider range
of anti-retroviral treatments available to those living with
HIV. This trend is encouraging but reliable access to treatment
is still something of a lottery. Civil society efforts must
be combined with those of organizations of people living with
HIV to demand that governments provide greater – and more
consistent - availability. However, treatment is not the quick
fix to the epidemic. Primary prevention needs to be re-energised
and the key to this is the greater inclusion of currently stigmatised
and marginalised sections of the community.
We must scale-up action on all fronts. Hence, one year ago,
we launched the Red Cross Red Crescent Global Alliance on HIV,
which aims to double our HIV programming by the end of 2010.
Some 50 of our 185 member National Societies have already actively
joined–up to “do more and to do better” in
HIV prevention, treatment. care, and support, and in addressing
stigma and discrimination. They are doing this by expanding
outreach through our network of members and volunteers in communities,
who are thus taking on practical responsibility and leadership.
A specific example is the Filles Libres’ project of the
Cameroon Red Cross Society. This targets one of the most vulnerable
and stigmatized groups: women who sell sex. Red Cross volunteers
make contact with these women – who often take up prostitution
as survival livelihood – to encourage them to get themselves
tested voluntarily and to protect themselves. They also work
with the clients of the sex workers to do the same. This campaign
is possible only because our volunteers include a number of
women who come from the same background as the sex workers,
speak the same language, understand the problems they face,
and get to trust each other. This is essential to break the
vicious cycle of infection: unprotected paid sex, infection
of the spouse when the ‘client’ returns home, and
the transmission of the virus from mother to child.
This example illustrates the daily challenges of HIV work: tackling
prejudice and stigma, re-enforcing prevention messages, helping
people living and dying with HIV, and not forgetting the factors
that underlie personal and societal vulnerability. The point
is that there is no substitute for communities having to take
charge of their own destinies and shaping their future –
for the better. This is a long-term task requiring permanent
commitment. There are no short-cuts.
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Dr
Mukesh Kapila, Special Representative of the Secretary
General for HIV
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