African women unite against Aids.

Access to Care and Treatment for Women, Children and Families was the theme of the Ninth International Conference of the Society for Women and Aids in Africa (SWAA), hosted by Sudan in July. Sister Namibia was invited by the UNIFEM Southern Africa Regional Office to share the Namibian experience with regard to treatment and care. Natasha Tibinyane reports.

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The conference was attended by SWAA members and gender and Aids activists from 13 African countries. Delegates were initially disappointed with the programme, which many saw as a platform for the Sudanese government to downplay the impact of HIV and Aids on this Islamic country ruled by the military. Presentations by Sudanese academics and doctors focussed mainly on scientific studies and were not relevant to the activists and home-based care workers as they did not at all address issues of care and treatment.

However, after negotiations the programme was adjusted and delegates were given the opportunity to learn from each other through sharing good and bad practices from their countries. Delegates from Ghana, Nigeria, Sudan, Uganda, Rwanda, Burundi, Senegal, Niger, South Africa, Kenya and Malawi gave Namibia overwhelming applause after hearing about our state run Orphan and Vulnerable Children Programme, and that policies are in place and steps being taken to roll out the Pilot Prevention of Mother To Child Transmission Programme, provide Post-Exposure Prophylaxis (PEP) for rape survivors and health workers as well as Highly Active Antiretroviral Therapy (HAART).

In the other countries represented in Khartoum, HIV and Aids programmes focus on prevention rather than treatment and care, and antiretroviral therapy is only accessible to those who can afford it. Beside South Africa with its groundbreaking Treatment Action Campaign, Namibia was the only other country to have organisations such as Lironga Eparu, the AIDS Law Unit of the Legal Assistance Centre and Sister Namibia that lobby for access to treatment and raise awareness on access to treatment as a human right. Unfortunately Botswana was not present at this conference, as it would have had many lessons to share on its advanced government-led roll out of treatment to all people living with HIV and Aids.

An interesting presentation by a UNIFEM team that did research in Kenya, Somalia and Ethiopia on women's increased risk to HIV infection emphasised that prevention and treatment strategies should address cultural and social practices that make women and girls more vulnerable to infection. An example of this is female genital mutilation (FGM), which is still widely practiced in 29 African countries, including Sudan.

In their presentation, the Sudanese Women's Union noted that one of their biggest challenges is to change the mindsets of people, including women, on this harmful practice. There are many dangers attached to this practice: wound infection, extreme menstrual pain caused by the blockage of menstrual blood, painful sexual intercourse and difficult childbirths are common. The added risk of HIV infection is also a reality, as the sharp object used is in many cases not sterilised and wounds may fester for a long time.

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With regard to social factors that expose girls and women to the risk of HIV infection, a study by Khartoum gynecologist Dr Abdel Hadi Ibrahim found that there is a lack of knowledge about safe sex among high school and university students as there is no sex education to promote safe sex in schools and universities in Sudan.

"Promiscuity is becoming common among poor school girls--I have seen many young school girls begging in the streets and they can readily have sex for money if they are approached," Ibrahim said. "These girls have never heard about condoms, let alone use them." According to Ibrahim poor university students turn to prostitution to pay for their studies, while men have the general impression that condoms reduce sexual pleasure and thus refuse to use them.

Another high-risk group is housewives with absent husbands. Ibrahim said many husbands leave the home to work in the Gulf countries and often stay for years without sending money home. Having no money, with a family to support, many of these women turn to prostitution and do not demand condom use.

The impact of HIV and Aids is not yet felt in Sudan as it is in Sub-Saharan Africa, but experts fear that if the current situation of denial and religious preaching continues, the country could soon find itself in the nightmare we are engulfed in now. And, sadly, Sudanese women will, just like their southern sisters, bear the brunt of the epidemic.

The conference ended with a call by the Society for Women and Aids in Africa on all African governments to spend less money on wars and more on providing care and treatment to those infected and affected by the pandemic. Men were also called upon to join women in caring for the sick. The next SWAA International Conference will be held in Kigali, Rwanda in 2005. Hopefully by then all member countries will provide access to care and treatment and the burden on the women of this continent lessened.