HIV/AIDS and Botswana’s Battle

In the 1990’s I used to feel like a blanket of sadness covered the country. People were dying everyday it seemed. No family was immune from loss, including mine. You wouldn’t see someone for awhile and then you didn’t want to ask as it was likely they were dead. We went to so many funerals. Achingly sad funerals of people far too young to die. I think about all of those dead and how if they could have lasted just a few more years they would have been saved. Now the government gives out free ARV treatment, so those same people would likely have survived and they would still be with us today.

The government in so many ways must be applauded for their efforts regarding HIV/AIDS. Former President Mogae, unlike many presidents around the world, never hid the problem. We are a small country, only 1.6 million, and he knew if nothing was done we could perish, all of us. That’s how it felt at that time anyway.

I was under the impression that things were getting better, but in yesterday’s Daily News (the state newspaper) the headline reads “Botswana leads in HIV/AIDS Prevalence”. According to a speaker from Scottish Livingstone Hospital in Molepolole in the south of the country, Botswana is still number one in Southern Africa for the prevalence of HIV/AIDS. I found the article so disappointing. I really thought we were getting better.

Part of the problem might be a disconnect between traditional practices and modern life. PSI Botswana is running an advertising campaign about ‘the small house’ and how it fuels HIV infection. Traditionally it was accepted to have concubines and this is what the small house refers to. But there were rules that governed this behaviour. What has happened now is the traditional practice is maintained without the rules, which were lost along the way.

When a young woman gets married she is taken to the side to sit with the older, married women to be told the ways to be a good wife. Among the advice is that a married woman should never ask a husband who is coming home late where he has been. Again there were reasons for this. Those reasons have been forgotten, but men have held tight to the practice. A wife who queries a husband arriving late in the night is a bad wife needing a sharp clap or a visit to her uncles for a complaint.

Both of these practices lead to concurrent relationships which is one of the drivers of HIV/AIDS in the country. Culture is often a sacred cow that should not be questioned or tampered with, but sometimes cultural practices that are causing harm should be dropped or at the very least questioned and better understood.

Botswana’s Vision 2016 has as one of its goals zero new HIV infections by 2016. Something is not working if after spending millions of Pula we are still having the highest prevalence rate in the region. We better change tactics if we want to reach that 2016 goal.