Mail & Guardian (Johannesburg) - June 23, 1995
Clive Simpkins

Latest World Health Organisation statistics indicate that sub-Saharan Africa, home to roughly 10 percent of the world's population, has about 70 percent of the world's HIV and Aids victims.

In South Africa's neighbouring states, health authorities, basing their figures on representative samples from ante-natal or sexually transmitted disease (STD) clinics, report a minimum HIV infection rate of 20 percent. This figure is regarded as conservative, because significant numbers of HIV or full-blown Aids cases go unreported.

Kwa-Zulu/Natal continues to lead the provinces in South Africa, with what is believed to be a 21 percent HIV infection rate.

Politicians continue to engage in petty squabbles. Business people bemoan the damage to the "economic engine room of Africa" that such squabbles cause. Yet the engine is running on a leaking gas tank, caused by an ever-increasing HIV rate which threatens to cut off the very labour force required to keep the engine

Those involved in community Aids education know that the challenges of Africa are unique. We are dealing with tradition, suspicion and superstition which make it extraordinarily difficult to alter sexual behaviour.

One dear old man recently said he refuses to use condoms because it's the equivalent of, "tying up my children in a sack". He uses the withdrawal method, which of course, is no protection from HIV.

Our challenge is to educate within the framework of these sometimes tragically funny misconceptions. Pooh- poohing or deriding them doesn't invalidate them for the people who believe them. We need to find and use education mechanisms that cut through the clutter of such ill-informed thinking.

Recently, an organisation sent a 24-year-old woman into rural tribal areas to speak to tribal elders -- males of 55 and upward -- on Aids, STDs, family planning and, specifically, vasectomy. I am stunned that they can expect chauvinists hailing from such a tradition to discuss their testes with a female young enough to be a

Among organisations dealing with HIV and Aids in Africa, the petty politicking, nepotism, bickering, rivalry and bitchiness is as bad as in competing theatre companies.

Government health departments are perceived as intractable, out-of-touch bureaucracies. Non- governmental organisations are perceived -- often legitimately -- as fat-cat, tokenist pretenders to the health-care crown. Instead of education efforts being used synergistically, they become fragmented by

Where is the big-hearted and big-minded person who will pull all these strings together so they play the same tune before we have no country or health care system

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Always watch for outdated information. This article first appeared in 1995. This material is designed to support, not replace, the relationship that exists between you and your doctor.

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