Zimbabwe’s Children Are the Battlefield in War to Contain HIV/AIDS

Many children under 15 in Zimbabwe discover their HIV status only when they fall critically ill later in life. Credit: Jeffrey Moyo/ IPS

Many children under 15 in Zimbabwe discover their HIV status only when they fall critically ill later in life. Credit: Jeffrey Moyo/ IPS

By Jeffrey Moyo
HARARE, Jan 17 2015 (IPS)

Fifty-one-year-old Mateline Msipa is living with HIV. Her 17-year-old daughter, born after Msipa was diagnosed with the virus, may also have it, but she has never been tested.

“My daughter is not aware of my HIV status and with the stigma associated with the disease, it is hard for me to now open up to her about my status,” Msipa told IPS.“Talk of rejection, talk of stigma and discrimination about HIV-positive people here has rendered me confused on whether or not I should get tested for HIV/AIDS, although I don’t know what killed my parents.” — 13-year-old Tracey Chihumwe

Msipa’s daughter says she has never attempted to undergo an HIV test despite Zimbabwe’s revised testing guidelines allowing children of her age to get one without parental consent.

“I have no reason to get tested for HIV because I have never engaged in sexual intercourse before,” the 17-year-old told IPS.

Figures show that thousands of children in Zimbabwe are infected with HIV – presenting a major battlefield for government efforts to defeat the spread of HIV /AIDS nationwide.

The U.N. agency UNAIDS estimates that nearly 200,000 children from birth to age 14 have the virus but are not in treatment because they have not been properly tested. It is a trend that researchers term “suboptimal” counseling and testing in that southern African country.

“Children often get tested for HIV [only] when they fall critically ill, which usually doesn’t save them from dying,” Letwin Zindove, an independent health expert who works as an HIV/AIDS counselor here, told IPS.

The new estimate threatens to dash the southern African nation’s effort to meet a U.N. goal of reversing the incidence of infection in the population by 2015.

Older children – between six and 15 – who might have acquired HIV at birth are especially vulnerable to a major outbreak of full-blown AIDS. A study last year by the London School of Hygiene and Tropical Medicine found this group received inadequate access to provider-initiated HIV testing and counselling by primary care-givers.

Lack of clear national standards for HIV/AIDS testing leads to confusion and missed diagnoses in some cases. Credit: Jeffrey Moyo/ IPS

Lack of clear national standards for HIV/AIDS testing leads to confusion and missed diagnoses in some cases. Credit: Jeffrey Moyo/ IPS

The study found health-care workers were reluctant to offer testing which could expose the child to abuse if he or she tested positive. On top of this, long waiting periods for appointments also hindered routine testing and counseling.

Last year, Zimbabwe launched its revised national guidelines for HIV testing and counselling with special emphasis on couples, children and adolescents as it stepped up efforts to halt the spread of the virus ahead of the 2015 deadline of the U.N. Millennium Development Goals (MDGs).

Under these guidelines, a child aged 16 years or older is eligible to give full consent for HIV testing and counselling.

However, the study found that many healthcare workers don’t fully understand the new guidelines.

“They expressed confusion about the age at which a child could choose to test him/herself, what type of caregivers qualified as legal guardians, and whether guardians had to undergo testing themselves first,” it said.

The appearance of a slow-progressing HIV disease among children has also contributed to dangerous delays in testing. New research has found that a substantial number of HIV-infected children survive to older adulthood. Delaying testing and diagnosis until symptoms appear results in a high risk of chronic complications such as stunting and organ damage.

Under the U.N.’s MDG Target 6A, countries should have halted new infections and begun to reverse the spread of HIV/AIDS by 2015.

Zimbabwe’s numbers of HIV incidence may be high (14.7 percent of adults) but the numbers are higher yet in South Africa (17.8 percent), Botswana (23 percent), Lesotho (23.6 percent), and Swaziland 25.9 percent.

Countries with low numbers are Mali, Guinea, Burkina Faso, Benin, Sudan, Senegal, Niger, Mauritania and Somalia – ranging from 1.0 percent to 0.7 percent.

While most countries are achieving a measure of success towards the U.N. goal, two have been a major health care disappointment.

Uganda, once hailed as a Cinderella success story, and Chad have seen a rise in infections. It is a disappointing turnaround from the 1990s when an aggressive public awareness campaign that urged medical treatment and monogamous sexual relationships led to a precipitous drop in infection rates in Uganda.

In 2012, H.I.V. infection rates in Uganda were seen to have increased to 7.3 percent from 6.4 percent in 2005. Over roughly the same period, the United States, through its AIDS prevention strategy known as Pepfar, or the President’s Emergency Plan for AIDS Relief, spent 1.7 billion dollars in Uganda to fight AIDS.

Activists say children are not immune to the deep-rooted stigma surrounding HIV/AIDS here — another barrier to testing.

“Zimbabweans are one huge community, closely-knit, and once a child is tested for HIV, it becomes difficult for it to remain confidential, resulting in any child tested becoming exposed to stigma,” Sifiso Mhofu, an affiliate of the Zimbabwe National Network of People living with HIV, told IPS.

This problem is very real for orphans like 13-year-old Tracey Chihumwe (not her real name) from Mabvuku, a high-density suburb of Harare, the Zimbabwean capital.

“Talk of rejection, talk of stigma and discrimination about HIV-positive people here has rendered me confused on whether or not I should get tested for HIV/AIDS, although I don’t know what killed my parents,” Chihumwe told IPS.

The Zimbabwean government is now struggling to ensure to that 85 percent of the population – including children and adolescents – knows their HIV status by the end of this year, in a desperate bid to meet the MDGs deadline in December.

But this will not be an easy task.

“Despite revised guidelines of HIV testing for children, pockets of resistance to get children tested for the virus exist from children themselves, parents and guardians as well,” a top government official, who requested to remain anonymous for professional reasons, told IPS.

Edited by Lisa Vives and Kitty Stapp

Escape Route Towards Social Inclusion for War-Disabled Gazan Youth

Samah Shaheen (right), one of Gaza’s many disabled young people, joined the Irada programme to acquire expertise, learn computerised wood carving and escape social marginalisation. Credit: Khaled Alashqar/IPS

Samah Shaheen (right), one of Gaza’s many disabled young people, joined the Irada programme to acquire expertise, learn computerised wood carving and escape social marginalisation. Credit: Khaled Alashqar/IPS

By Khaled Alashqar
GAZA CITY, Jan 17 2015 (IPS)

The Israeli attacks that the Gaza Strip has suffered in recent years have left in their wake a large number of young people who have come up against a further barrier to their creative energies – physical disability caused by military aggression.

Institutions here are increasingly facing the challenge of developing rehabilitation programmes to help support these physically disabled Gazan youth cope with living under the existing harsh political, economic and social conditions.

One of these programmes – known as “Irada” (“will” in Arabic) – is providing young people who have been disabled by war with vocational training with the ultimate objective of helping them earn their own livelihoods.

Launched by the Islamic University of Gaza, the Irada programme aims to support, train and reintegrate physically challenged young people in social and economic terms and boost community trust in the abilities of this so far marginalised group. More than 400 persons with all types of disabilities have already received rehabilitation and training.“After I joined the [Irada] programme and learnt computer skills for carving and decoration on wood, I now have a career, earn well and I am seriously thinking of opening a workshop” – Samah Shaheen, a 33-year-old physically disabled woman from Al-Bureij refugee camp

Irada project director Emad Al Masri told IPS that the project concept was initially developed for the massive number of young people who became disabled as a result of the Israeli war against Gaza in 2008. The project received support from the government of Turkey for the building construction to house Irada’s academic and vocational training programmes.

“The basic idea of the project is to help disabled people and reintegrate them into the community and help them to be productive instead of being seen as a burden,” Al Masri said.

Samah Shaheen, a 33-year-old from Al-Bureij refugee camp, has a physical disability that makes it difficult for her to engage in community activities. She joined the Irada programme in an attempt to acquire expertise and learn computerised wood carving. She spent more than six months in training before moving on to practice her new skills within the community under Irada supervision.

“I spent several years of my life jobless due to my disability, and also because I had no experience,” Samah told IPS. “After I joined the [Irada] programme and learnt computer skills for carving and decoration on wood, I now have a career, earn well and I am seriously thinking of opening a workshop because of the overwhelming response to the ornate wood furniture products that I have made.”

Central to the Irada rehabilitation programme is to follow up with the disabled people who have received training after leaving the programme in order to ensure their integration and participation in the labour market.  Part of this follow-up strategy also includes monitoring their progress in the workshops and factories where they are employed, and offering professional support if needed.

Because of its success, the Irada programme has been awarded funding by the United Nations Development Programme (UNDP) to help programme graduates start up small business projects, develop their economic independence and enhance their production profile.

Tariq Sha’at, NGO Coordinator for UNDP, told IPS that “UNDP allocated 150,000 dollars to establish centres for the production of home furniture throughout the governorates of the Gaza Strip and help 90 disabled trainees to manage their own businesses, continue their lives and reintegrate into the society naturally.”

Adding further success to the promising and successful Irada programme, three female information technology (IT) students from the Islamic University of Gaza have designed the first application to enable visually impaired people to write in Braille language on smart phones in Arabic.

Seen as a major breakthrough, visually impaired people can now download and install the application for performing all operations, including calls and text messaging. It also allows physically impaired people to use smart phones with high efficacy and facilitates communications with people in the wider society.

Dr. Tawfiq Barhom,  Dean of the Faculty of Information Technology, explained to IPS that “this group of female students was able to provide a great service to the community of visually impaired people, in addition to winning a global competition in which the application was selected as one of the five best projects for developers from among 2500 projects.”

Students are now trying to develop this application even further by increasing the number of languages supported to facilitate use by larger groups worldwide. Israa Al Ashqar, one of the students on the project team told IPS that the project came about because of the marginalisation experienced by visually impaired people in society and their increased isolation as a result of their inability to use social media and smart phone applications.

“The application will provide a Braille keyboard for every programme used by visually impaired people on mobile phones which will allow them to use social media and communicate with their community naturally. This will in turn increase the chances for this marginalised group to integrate into local and global society,” she said.

Together, the Irada programme and the Braille smart phone application represent a serious attempt by universities and students in Gaza to support an important section of the community that has not only suffered from wars and traumas but also hopelessness and isolation within Gazan society.

They are a tangible demonstration that the people of Gaza have the will and the talent to work together and develop opportunities, where possible, for an inclusive society.

Edited by Phil Harris