[list_indonesia] [ppiindia] In Africa, marriage can kill
- From: "Ambon" <sea@xxxxxxxxxx>
- To: <"Undisclosed-Recipient:;"@freelists.org>
- Date: Thu, 31 Mar 2005 02:42:42 +0200
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Nicholas D. Kristof: In Africa, marriage can kill
Nicholas D. Kristof The New York Times
Thursday, March 31, 2005
LIVINGSTONE, Zambia Sex kills all the time, particularly here in Africa. But
prudishness can be just as lethal.
.
President George W. Bush is focusing his program against AIDS in Africa on
sexual abstinence and marital fidelity, relegating condoms to a distant third.
It's the kind of well-meaning policy that bubbles up out of a White House
prayer meeting but that will mean a lot of unnecessary deaths on the ground in
Africa.
.
The stark reality here is that what kills young women here is often not
promiscuity, but marriage. Indeed, just about the deadliest thing a woman in
southern Africa can do is get married.
.
Take Kero Sibanda, a woman I met in a village in Zimbabwe. Sibanda is an
educated woman and lovely English-speaker who married a man who could find a
job only in another city. She suspected that he had a girlfriend there, but he
would return to the village every couple of months to visit her.
.
"I asked him to use a condom," she said, "but he refused. There was nothing I
could do."
.
He died two years ago, apparently of AIDS. Now Sibanda worries that she and her
beautiful 2-year-old daughter, Amanda, have the AIDS virus as well.
.
Encouraging more use of male and female condoms might reduce such tragedies,
for there's a disdain for condoms in many countries that social marketing might
change (there's an African saying: "Who wants a sweet with the wrapper still
on?").
.
The fact is that condoms have played a crucial role in the campaigns against
AIDS that have been relatively successful, from Thailand's "100 percent condom
program" to the efforts in Uganda, Cambodia and Senegal. And condoms don't
cause sex any more than umbrellas cause rain.
.
In theory, everybody agrees on how to prevent AIDS: the ABC method, which
stands for abstinence, being faithful and condoms. But the Bush administration
interprets this as ABc. New administration guidelines stipulate that
U.S.-financed AIDS programs for young people must focus on abstinence or, for
those who are already sexually active, "returning to abstinence."
.
Here in Livingstone, Zambia, I visited Corridors of Hope, a U.S.-financed
center for young people that has proved cheap and effective in reducing HIV
among prostitutes and long-distance truck drivers. One prostitute in the
program is Mavis Sitwala, an orphan (probably because of AIDS) who is
supporting her five siblings and one child. She says that truck drivers pay $1
for sex with a condom or $4 for sex without.
.
"At times, you need food or money to pay the rent," she said, "and so even if
he won't use a condom, you agree."
.
Encouraging Sitwala to "return to abstinence" isn't likely to get far, but
encouraging more use of condoms might save her life, the lives of her clients
and the lives of her clients' wives. Indeed, the Bush administration recognizes
that, allowing condoms to be handed out to prostitutes in programs like
Corridors of Hope - but not to society as a whole.
.
There's a bit of wiggle room in the administration guidelines. But the U.S.
Center for Health and Gender Equity reports that in several countries, the
United States is already backing away from effective programs that involve
condoms.
.
The irony is that Bush's plan to tackle AIDS in Africa - spending far more than
any previous administration - could be one of his most important legacies. It
tackles one of the world's most important humanitarian challenges: At present
infection rates in Zimbabwe, 85 percent of today's 15-year-olds will die of
AIDS.
.
So I wish Bush would reach out beyond the ideologues to a real expert, like
Loveness Sibanda. I met Sibanda (no relation to the other Sibanda) and her
child in her village in Zimbabwe. She is 26, and her husband works in the city
of Bulawayo, where she has heard that he has a girlfriend. Every few months he
comes back to the village and insists on sleeping with her, without a condom.
She now dreads these visits.
.
Perhaps the White House thinks it has the moral high ground when it preaches,
completely irrelevantly, to women like Sibanda about the need to be faithful.
But it strikes me as hypocritical to pontificate about virtue while pursuing an
ideological squeamishness about condoms that risks condemning Sibanda and
millions like her to die of AIDS.
.
.
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