Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Mail & Guardian (Johannesburg) - October 15, 2003
Vicki Robinson And Tebogo Motsuku
A paper called An Exploration of the Shelter and Services Needs Arising from HIV/Aids, was delivered by Professor Richard Tomlinson at a conference, Urbanisation and Housing Challenges: Cities in Africa, this week in Sandton. The conference was organised by the Gauteng Department of Housing, with United Nations Habitat, the Cities Network, the Johannesburg Metropolitan Council, and Witwatersrand University, to identify challenges facing African countries in housing development.
According to Tomlinson (a lecturer at the Graduate School of Public and Development Management at Wits University), "while there are tremendously important housing programmes, with home-based care and foster care for orphans ... one does not find programmes that deal with changes in shelter needs [of families with ill members] during the period from infection to death, and then to household recomposition."
He argues that death from Aids-related causes is different from other forms of death, for example in a car accident, and thus its impact on shelter and services needs will differ.
These differences include the age at which the death occurs. "Age is important because the death of a child will have little impact on a household's ability to pay for shelter and services, whereas the death of the main income earner has a major, even catastrophic impact."
The period during which "HIV/ Aids health care is needed can be a number of years ... during which a family experiences increasing expenditures, asset reduction and declining incomes".
Given the numbers involved, "traditional support systems often become overwhelmed", while "poor quality shelter increases the risk of viral and bacterial respiratory infections". As far as gender is concerned, "all too often the most vulnerable orphans result not from the death of both parents, but from the death of the mother".
The report notes that without adequate water and sanitation "there is greater risk of HIV and other infection through contact with body fluids during care of people".
Tomlinson said such problems were highlighted in slums where there is poor access to services, where stigma causes "others in the community to prevent that person from having access to shared ablution facilities", and where poverty forces families to prioritise "medical care and food" rather than shelter.
The answers, he said, lie in drawing attention to the role of local government, which has been playing ostrich. When it comes to shelter and services in South Africa "presumption and practice are poorly aligned".
"It is assumed that local governments are delivering services to the bulk of their households. This is seldom the case. It is assumed that local governments have the capacity to deliver, say, extra water to HIV/Aids-affected households ... including slums. This is most unlikely. It is assumed that services are being metered, billed and paid for ... [But] one can generalise and say [this is not the case]."
Tomlinson said: "Local governments will have to work in partnership with bulk service providers, on the one hand, and with faith-based, community and other NGOs, on the other, in order to begin to address shelter and services needs arising from HIV/Aids."
The conference also highlighted plans to establish social housing communities for people migrating from rural areas into cities. Gauteng Minister of Housing Paul Mashatile said "the department has a strategic plan for the allocation of a R6-billion grant to rural development".
He said the main aim of the conference was to "ensure ... the provision of social services, infrastructure and sewerage systems".
031015
MG031007
Copyright © 2003 - Daily Mail & Guardian. For information about the content or for permission to redistribute, publish or use for broadcast, contact the publisher.
AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, the National Library of Medicine, Pacific Life Foundation and donations from users like you.
Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.
AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.
Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .