Introduction: AIDS/HIV (auto-immunodeficiency syndrome) is quickly becoming the worst disease the world has ever seen, pulling in numbers of death tolls that exceed those of the bubonic plague. “By 2010 its death toll will be higher than that of the two world wars combined, and it will soon be worse than the total claimed by all wars put together,” (Hunter 7). HIV is the virus that causes AIDS; symptoms only become apparent after the virus lies quietly within the infected person for seven to ten years and most HIV-positive people feel so healthy during this period they do not get tested. This leads to easy passing of the virus, with the infected person having no idea what they are doing.
There are five ways in which HIV can be contracted (Hunter 9); ordinary heterosexual intercourse is the most common of the ways. Bisexual or homosexual intercourse and injecting drug use are also very popular ways. The fourth way is transmission from mother to child in utero and during birth, as well as breast feeding. The final way that this disease is usually contracted is through infected blood transfusions that would be used to help hemophiliacs or a case of extreme loss of blood.
Two of the major driving forces in the spread of HIV/AIDS are poverty and labor migration. These are issues that have no sexual bias, but nevertheless lead people into behavior or circumstances that place them at risk for infection of HIV. The following table gives the figures for the estimated number of adults and children living with AIDS at the end of 2003 in : (United Nations South Africa Fact Sheet 2) This essay will take a look at this incredibly dangerous epidemic particularly in South Africa and will answer the following questions: Why is South Africa so heavily plagued with this disease as opposed to other areas of the world and why has the government been largely unsuccessful in its attempts to deter the spread of the virus? What areas does the South African government need to focus on to improve the current crisis with AIDS? What kind of economic impacts could HIV/AIDS have on South Africa’s future? Why is South Africa so heavily plagued by this virus as opposed to other areas of the world and why has the government been largely unsuccessful in its attempts to deter the spread of the virus? There are seven countries in southern Africa that make up the global epicenter of the AIDS epidemic. These countries are Namibia, Botswana, Swaziland, Zambia, Zimbabwe, Lesotho, and South Africa. In the following table the prevalence rates of HIV/AIDS in these different countries is shown through different splices of the population, which can be evaluated and compared.
(Whiteside 4) These countries individually struggle with AIDS for different reasons, but all of these neighboring countries are interconnected with the increase of the AIDS epidemic. This will be explained further, later in the essay. The notion of South Africa being heavily plagued by AIDS as opposed to other areas of the world is one that has not been completely solved. While no one has a definitive answer, there are definitely inferences that can be made according to analysis of the African culture and specifics to South Africa, as well as an analysis of economic issues that contribute to the virus’ prevalence. Initially there was an assumption that people in Africa must simply be more promiscuous than people in the West. Nana K.
Poku, writes of Professor Nathan Clumeck from the Universit’e Libre in Brussels who recently claimed in a 2003 edition of Le Monde that, “sex, love and disease do not mean the same thing to Africans as they do to West Europeans because the notion of guilt does not exist in the same way as it does in Judeo-Christian cultures of the west,” (Poku 194). This notion, however, is simply a development of an old stereotype that was used to justify the need that colonialists had for social control within their colonies. There is very little evidence that would support this theory and most African cultures suggest the exact opposite; in many African cultures, sexual modesty is highly emphasized for African women (Poku 194). Sexuality is considered a gift that should be used for the purpose of procreation. As a result of this, any initial sexual relationship that develops is intended to be the basis on which a marital relationship will be formed (Poku 194). While in the West, the concept of having a boyfriend or girlfriend is just a part of the life of a teenager or young adult, there is no parallel for this concept in most traditional African cultures.
No one has ever shown that people from the core areas of the epidemic in Africa are more sexually active than people from Western Europe (Poku 194). These facts imply that it is not just the sexual behavior of Africans that is causing AIDS to be so prevalent, but that there is something in the culture of Africa which is conducive to sexually transmitted diseases (STDs). Several cultural issues that are relevant to the social structure of South Africa have implications in the level of ease at which this disease is transmitted. South Africa has always had a patriarchal base and the lack of progression from this base has led to the status of women in their society being very low; this allows for male domination in overlooked areas, such as relationships, and results in women’s great difficulty in obtaining means to protect themselves in a sexual context. In societies where women are reliant on males for some form of support, it makes it very difficult for a woman to stand up to the male that she shares a relationship with. Women in this position develop a certain tolerance to the situation in which they accept issues that are the cause of many divorces in the west (Barnett and Blaikie 162); they learn that because of their economic dependence on their husband, they have to accept that he shares multiple sexual partners and this has, unfortunately, become the reluctant norm.
One must keep in mind as well that ultimately it is the man’s decision whether or not to wear the condom. A female that refuses sex without a condom from her husband may face some sort of abuse, whether it is verbal or physical; this is a definite deterrent. In addition to the low status that women share in this society, there are also cultural stigmas about certain forms of protection, which complicates the process of HIV prevention (web in south africa. htm). Resistance to change high risk behaviors that are often centered on cultural notions is a great contributor to the spread of HIV/AIDS (web in south africa.
htm). Condom usage is one of these notions and is a serious issue in South Africa; indeed, in all its surrounding countries. It is effected by the serious poverty that many HIV-positive South Africans live in, as well as the economic status of a country that is going through difficult times. There has been a great effort to persuade people to use condoms all over the nation, furthered by the import of millions of condoms to Africa (AIDS Analysis in Africa 6), but the process of getting people to actually use them is far more complicated than it was initially understood to be. It is very difficult to break the barrier of the cultural attitudes towards condom usage that labels it as a waste of time, preventing more intimate contact with a partner, or even belittling the power of the sperm by obstructing its entry into the vagina.
Women have great difficulty persuading their partners to use condoms due to gender relations, religious beliefs, and in a place like South Africa, politics become an issue as well (Barnett and Blaikie 160). Religious objections to condom usage are more of a concern in predominantly Catholic nations such as Uganda; instead of this issue to confront, South Africa has to deal with the effects of a long-lasting racial divide within the country. These people have shared a rocky racial history involving the Dutch Afrikaner colonialists and the native South Africans. There was extreme racial segregation and it has only been in recent years that black South Africans have freed themselves from persecution.
Racial relations are still shaky and people are still not sure if they trust that the divide has been surpassed. For this reason it is difficult for the government to encourage the usage of condoms because, understandably, the black population is quite suspicious of any initiatives the white minority government promotes. Barnett and Blaikie clearly show that this adds another dimension to the cultural attitudes towards condoms in that now there is also issue that blacks interpret the advice to use condoms as a sort of conspiracy by the government to reduce the rate of black population growth (162). Putting aside the cultural attitudes, there are circumstances that are more difficult to change than a stubborn mindset; one of these circumstances is poverty.
Life is very difficult for these South Africans and a person may find it difficult to adjust to using a condom because it requires a lot more than a westerner may realize; it requires electricity: organizations in favor of preventing the spread of AIDS advise couples to inspect the condom for any tears before usage (Barnett and Blaikie 161). It also requires running water or an available water supply for washing hands after usage; many times in these areas wells are loca ted far from home and the trips are waged wisely. In addition to those factors, people in these areas are living in extremely crowded conditions where disposal of the condoms may be a problem. Poverty extends further than just uncomfortable living conditions; many South African women who are poor are unable to find jobs turn to prostitution due to the lack of any options. Prostitution is a significant factor in the role of transmission of AIDS because of the multiple partners that the prostitutes share and the lack of knowledge they have of protected sex. Prostitutes are known as a high risk group.
Other high risk groups include ‘street youth’, male long-distance truck drivers, miners, military, and para-military groups (Bond, Kreniske, Susser, Vincent et al. : Akeroyd 13). On this topic, Akeroyd refers to Moses and Plummer, who said, “The commonalities of these disparate groups, such as urban residence, low socioeconomic status, their mobile or transient character, forced segregation of the sexes, and alienation or marginalization, point to some of the social and economic circumstances which underlie risky sexual behavior” (13). These marginalized groups are large contributors to the spread of the virus; ‘street youth’ transmit the disease through unprotected vaginal or anal sex that is commonly used as a form of initiation or as a way to establish dominance amongst themselves (Hunter 27).
As for military and para-military groups, the risk of infection in African armies is anywhere between 20 and 60 percent and their risk of dying from AIDS is much higher than their risk of death in combat (Hunter 26). Soldiers are known for transmitting STDs either through voluntary or coerced unions. As for the truckers: “Malawian truckers have been blamed for the ‘highway of death’s weeping down into South Africa” (Bond, Kreniske, Susser, Vincent et al. : Akeroyd 17). Truckers that are alone and on the road tend to frequent with prostitutes for satisfaction.
With the mobility of both professions, transmission of the disease to other areas is made very easy. What areas does the South African government need to focus on to improve the current crisis with AIDS? Unfortunately there has been very little improvement in this situation, if any at all. Whiteside uses a study on HIV prevalence rates as measured by an annual survey of pregnant women in four countries. The graph that displays the results of this study is the following: (Whiteside 3) The graph reinforces that the rate of HIV-positive women, and pregnant women at that, is still increasing. This means that there are more mothers that are going to be victim to the virus and more orphaned children that fall into high risk situations that were discussed before. The high risk groups are marginalized and forgotten and this is a serious mistake.
The epidemic is so out of control that it has gone beyond the high risk groups and moved to a household level; the prevalence of AIDS can no longer be denied, and it will only be to the nation’s detriment to continue to do so. One of the main areas that the South African government needs to focus on is the improvement of sex education. As difficult as it may be to do, correct information about the virus itself must be widespread: the ways it is contracted, the ways it can be prevented, the fact that people need to be tested before they pursue further sexual relations. The cultural attitudes toward condom usage are an enormous problem and the only way to get past them is through furthering sexual education.
An issue that is largely influential in taking these steps is funding. The South African government is struggling with so many other things, such as dealing with a newly united nation, racially speaking. The economy does not have the resources it needs to fund programming for sexual education or elevate the welfare system to better education and consequently diminish the perpetuation of the cycle. If the government had the ability to provide the population with sexual education they would also have to be realistic about the information they are providing. There is a significant amount of denial in relation to both teenage sexual activity as well as homosexual activity (as well as all other marginalized high risk groups). It is unrealistic to assume that a nation that is already so deeply involved with this disease will all of a sudden flip 180 degrees and assume principles of condemnation of pre-marital sex.
Sexual education, while it may encourage people to practice abstinence, should really concentrate on the concept of protection. If people knew how to protect themselves and that it was socially acceptable to protect themselves, they most likely would. In addition to this the government has to focus on improving its welfare system to get women off the streets. Prostitution is a serious issue and most women do not do it because they enjoy it, they do it because they have no choice. South Africa needs to give all its people the freedom to choose. What kind of economic impact could HIV/AIDS have on South Africa’s future? There is potential for AIDS to have a serious impact on South Africa’s economic future.
Besides the social atrocities that the AIDS epidemic has already caused South Africa, the predicted increased death rate and drop in life expectancy will undoubtedly affect South Africa’s already distressed economy. The disease executes people in their most productive years causing many direct and indirect consequences for agriculture and non-agricultural firms. AIDS has the potential to have a large impact on some firms. Aids related deaths and illnesses of workers can do two things, increase expenditures and reduce revenues. Company’s costs increase when they have to pay for health care, the cost of a burial, plus finding and training a replacement for a deceased worker. Businesses will struggle more if they have chronic absenteeism which in turn would cause less experience and productivity (Ahwireng-Obeng and Akussah 21).
This progression of internal destruction amongst non-agricultural firms is simplified in to a flowchart. Negative Impacts of HIV/AIDS on non-agricultural firms: Like firms, agriculture will be affected by the loss of labor due to illness and death. On a small farm if one person becomes ill or dies loss of the labor from that person is detrimental. If this loss of labor happens at the wrong time it could greatly reduce the total harvest for that year. This could be especially bad in South Africa where food scarcity is a constant issue due to drought (Ahwireng-Obeng and Akussah 18).
In conclusion the AIDS epidemic in South Africa has pummeled the already fragile country and has the potential, if nothing is done to deter the disease, to throw this country further in to dejection. Alan Whiteside did an excellent job of describing the scope of the effects of the Aids epidemic when he wrote, “AIDS deepens poverty and increases inequalities at every level, from household to global. The epidemic undermines efforts at poverty reduction, income and asset distribution, productivity and economic growth” (13). The AIDS outbreak in South Africa is not a problem that with be remedied by one variable.
The battle against AIDS must first be identified by all factors involved as a problem. Denial by one or more groups will substantially deter the battle against the HIV/AIDS virus. In order for South Africa to rise up and win this fight it must attack the problem from all angles. It is the government’s job to educate its citizens of the disease and how to avoid it. It is the job of the citizens of South Africa to take their countries future in their own hands and start making more responsible decisions in their daily lives.
Last but not least it is important for the entire world to aid South Africa and Sub-Saharan Africa in their struggle to rise from the social and economic ruins that AIDS is rapidly creating. References 1. AIDS Analysis in Africa, Vol. 1, No. 2, May/ June 1991. 2.
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