THE ELECTRONIC BULLETIN OF THE SWISS PLATFORM FOR HIV/AIDS AND INTERNATIONAL COOPERATION August 2009

The human sperm is nutrition for the unborn child – that is a deeprooted firm conviction the Macua from Mozambique have. And it is a sound reason for couples to have sex during pregnancy. It is also a reason for the future mother to have sexual contacts even outside of her marriage if the husband is far away - thinking she only wants the best for her unborn child. Of course, needless to say that in so doing the risk of an HIV-infection grows.

Shared cultural ways and ideas of how to behave properly according one’s traditions are important tools, they are forging a society together and serve to keep somebody grounded. Today, some cultural ideas can however contribute to propagate HIV, having dramatic consequences for the child and its mother and father.

How do we deal with adverse cultural ideas in the framework of development cooperation?

A good example is the work of Wiwanana in Mozambique, an NGO supported by SolidarMed. Its name means mutual understanding and cooperation. Wiwanana first tries to understand the cultural concepts that may obstruct effective prevention. In a second step, the staff members talk about the delicate issues that are often a taboo. The methodology of „Peer education“, i.e. the information and education from boy to boy and from girl to girl, proved to be a promising strategy, as much as cooperating with the advisors of initiation rites such as traditional healers and elders of the village communities. A few years ago, it would still have been shocking and deeply offending to publicly talk about sex. Over time, this has changed. „Some values of our tradition are breaking away for the sake of our health“, explains a young women farmer.

Understanding cultural concepts of health and illness and using culturally sensitive means are vital aspects of an effective strategy in the struggle against AIDS. This was the consensus that the aidsfocus.ch Conference on „Culture and Condoms“ reached in May of 2009 in Berne. The new Bulletin by Medicus Mundi Schweiz, the Reader of the aidsfocus Conference offers an insight into the manifold interfaces of culture and AIDS. Field reports and stories of the experiences of our aidsfocus-partner organisations clearly reflect the problems and opportunities of a culturally sensitive HIV-prevention work as well as of a culture-oriented dealing with the illness and with the people affected. A highly recommendable reading!

Helena Zweifel Coordinator aidsfocus.ch

Ten years ago, the Swiss NGO SolidarMed started to support a “community empowerment in health” programme called “Wiwanana” in the District of Chiure, Northern Mozambique. With this article, the authors share some experiences related to traditional concepts of health, with important implications for HIV/AIDS prevention in the project area.

Wiwanana is a Macua word and means “mutual understanding and collaboration”. The so-called programme stands at the interface between the state health service providers and the communities, where it acts as mediator, moderator and educator. During the many community meetings and discussions on safe sex, HIV/AIDS and family planning held since the start of the programme, the importance of human sperm remains paramount and unshakable, and its consequences for HIV/AIDS prevention are worrying.

In Macua culture, men and women are equally convinced that human sperm bears the following qualities and characteristics: Energetic value to the woman who receives it during sexual intercourse; nutrition for the foetus during pregnancy; food to the pregnant woman; having polluted colostrum (“first milk”) and capable of polluting normal breast milk.

Individual health-related behaviour is influenced by many factors, including political, socio-cultural, economical, educational, personal and environmental. Each factor depends on various underlying variables, of which some weigh more and some weigh less. The collusion of all these variables will, at the end, result in a certain behaviour of a specific individual at a specific time point.

Working closely with the communities in rural areas, Wiwanana has generated a rich bouquet of experiences with the local culture and traditional health beliefs. In this example, the deeply rooted concept of the importance of sperm for women and foetuses has been identified as an important cause for sexual high risk behaviour. Taking it into account for the design of its interventions, Wiwanana is able to contribute to awareness building in young men and women, who think, debate and act on the AIDS pandemic and prevention measures in the District. (Bulletin of Medicus Mundi Switzerland No 113, August 2009)

http://www.medicusmundi.ch

The aidsfocus.ch conference in May 2009 looked at the complex inter-relationships of culture and HIV and AIDS. Based on experiences and knowledge of partner organisations and others, cultural sensitive approaches to prevention, treatment, care and support of were explored. The reader, the Bulletin of Medicus Mundi Switzerland No 113 reflects the presentation and discussions of the conference. The papers are complemented and enriched with stories, experiences, discussions and reflections on the issue. You may access the electronic version of the Bulletin on our website or send a mail to info@aidsfocus.ch for the printed issue.

http://www.medicusmundi.ch
http://www.aidsfocus.ch

Cordaid and partners reward and encourage leadership around the strengthening of home based care in responding to HIV and AIDS in the “global South” by awarding €15.000 for an organisation and €5.000 for an individual. They are seeking applications from organisations or individuals committed to supporting home based care as a necessary, effective, and community-based initiative – recognising home based care as an insufficiently resourced, under-valued and unrecognized solution for mitigating the effects of HIV and AIDS. Submissions can be sent up to 15 September 2009.

http://www.cordaidpartners.com

Johannesburg, 18 August 2009 - With South Africa's sixth H1N1 death confirmed on Monday, the government has issued a warning to people living with HIV, as well as other chronic conditions like heart disease and diabetes, to seek medical treatment early if they have even mild symptoms of the new influenza, also known as swine flu. Last week, WHO regional director Luis Gomes Sambo warned that countries such as South Africa, which are already shouldering high disease burdens of malaria, tuberculosis and HIV, were most vulnerable to epidemics like the H1N1 virus. (PlusNews)

http://www.plusnews.org

Kigali, 14 August 2009 - The tiny nation of Rwanda has emerged as the unlikely star of central Africa in making progress towards achieving universal access to HIV treatment, prevention and care. More than 70 percent of its people who need life-prolonging antiretroviral (ARV) drugs have access to them, prevention of mother-to-child transmission (PMTCT) services reach 60 percent of women requiring them, and 60 percent of children needing ARVs are on treatment. Experts put these successes down to political commitment at the highest level, which has enabled HIV actors to expand programmes nationally. (PlusNews)

http://www.plusnews.org

Phnom Penh, 28 July 2009 – The Cambodian government should urgently address dangerous conditions in a de facto AIDS colony it has created and immediately stop sending HIV-affected families there, more than 100 international HIV/AIDS and social justice organizations and experts said in a joint letter delivered on July 27, 2009 to Cambodia’s prime minister and health minister. In June 2009, the Cambodian government forcibly relocated 20 HIV-affected families living in Borei Keila, a housing development in Phnom Penh, to substandard housing at Tuol Sambo. (HRW)

http://www.hrw.org

Pretoria, 27 July 2009 - Fewer Zimbabweans are being infected with AIDS, and researchers speculate this is due, in part, to a battered economy that's leaving men short of money to be sugar daddies (older men who attract young girlfriends with gifts and money) and keep mistresses. The prevalence of the virus that caused AIDS fell from 23 percent in 2001 to 11 percent at the end of 2008. The study was based on tests of 18 746 women at a prenatal clinic in rural Zimbabwe. (Pretoria News)

http://www.thezimbabwean.co.uk

Cape Town, 20 July 2009 - Just three weeks into his new appointment, United States Global AIDS Coordinator Dr Eric Goosby outlined some of the changes that President Barack Obama’s administration will make to the country's global AIDS policy. Goosby began by reassuring that fighting AIDS would remain a central component of Obama's foreign policy. However, there would be a renewed focus on other priorities such as maternal and child health, and tropical diseases. Goosby also made it clear that scientific evidence rather than moral concerns would drive intensified efforts to reach high-risk groups - men who have sex with men, injecting drug users and sex workers - with HIV prevention and care.(PLUSNEWS)

http://www.plusnews.org

This new guidance package gives policy makers, programme managers, health professionals, donors and advocates an important tool to better support the sexual and reproductive health and rights of people living with HIV. With input from networks of people with HIV worldwide, the guidance package explains what global stakeholders in the areas of advocacy, health systems, policy making and law can do to support and advance the sexual and reproductive health of people living with HIV, and why these issues matter. (August 2009)

http://www.unaids.org

This new report by UNAIDS, its Cosponsors and civil society partners examines the issue of married or in long-term relationships women who are at risk of HIV infection due to their partners’ high-risk behaviours. It is estimated that more than 90% of the 1.7 million women living with HIV in Asia became infected from their husbands or partners while in long-term relationships. By 2008, women constituted 35% of all adult HIV infections in Asia, up from 17% in 1990. The myriad issues that are at the root of the problem are discussed. The strong patriarchal culture in the countries of Asia, intimate partner violence, including sexual violence, the large-scale migration and mobility of populations in Asia and HIV-related stigma and discrimination all play a role in the vulnerability of women to HIV. (August 2009)

http://data.unaids.org

The goal of achieving universal access to treatment by 2010 has preoccupied the global AIDS community in recent years, but a new report warns that not preparing for the changing treatment needs of people living with HIV will doom the sustainability of treatment programmes in developing countries. Over the next decade an increasing number of patients on inexpensive first-line antiretroviral (ARV) drugs in low-income countries will need second-line ARVs, which currently cost at least seven times more. Many patients will also need to be switched to newer, less toxic first-line drugs, which have fewer side-effects but are at least double the price. (July 2009)

http://www.plusnews.org
http://www.ip-watch.org

The new UNAIDS report looks at the contribution of AIDS-related public-private partnerships to the six building blocks of health systems: service delivery; human resources; information; medicines and technologies; financing; and leadership. It highlights how the AIDS response has been a strong catalyst in the establishment of public-private partnerships for health, particularly in Africa. Many of these partnerships initially focused on HIV but they later expanded to cover wider health issues. Good practices have been identified taken into consideration their sustainability, their integration in the national AIDS control plan, their measurable results, etc. (July 2009)

http://data.unaids.org

Among the many groups and individuals affected by the spread of the HIV virus worldwide are children. Grandparents and other relatives, religious and secular community groups, and regional, national, and international development groups have developed a variety of approaches and resources that specifically address the issues faced by AIDS orphans, other vulnerable children, and the people caring for them. This collection of summaries is intended to indicate a few examples of strategies that work to support caregivers and build capacity for peer support and efforts to raise awareness and to advocate for this population group. (August 2009)

http://comminit.com

Basel | Patriarchy is a specific form of male domination based on the powerful role of the father as the head of the household. The patriarchal system affects family life and has been identified as a significant risk factor behind intimate partner violence. Drawing on research conducted with rural Zulu male youth, the presentation by Reshma Sathiparsad, University of KwaZulu Natal, Durban, and the discussion will focus on the traditional and the changing positions of men and women in the home and how this has influenced relationships generally. This is the first talk in the series ‘Violence: Gender Perspectives from Ghana and South Africa’ organized by Gender Studies, University of Basel.

http://www.aidsfocus.ch

Biel | cinfo: The objective of this advanced seminar for those working in International Cooperation organizations, their accompanying partners, and IC consultants is to refine the understanding of the complex and contradictory dynamics that link culture and development. Participants will become aware of the importance of intercultural communication as a factor in successful international cooperation and develop a realistic sense of their own capacities and limits in the realm of intercultural dialogue. They will acquire useful methodologies for analyzing intercultural communication experiences.

http://www.cinfo.ch

Biel | cinfo: HIV and AIDS are a sad reality in a number of countries involved in International Cooperation (IC). It affects not only every aspect of the lives of the people concerned, but also considerably impacts the life and work of IC expatriate personnel. This seminar has the objective of working with participants so that they can better manage this challenge. The participants will explore various levels of impact which the epidemic of HIV / AIDS can have on the life and the work of expatriate personnel and consider various social and professional situations linked to HIV / AIDS that they may need to address.

http://www.cinfo.ch

Berne | The annual meeting of aidsfocus.ch, the Swiss platform on HIV/AIDS and international cooperation, is an important forum for the sharing of information and experiences. Besides the annual report and accounts, there will be a window open for sharing of information and experiences. Invitation with agenda will follow. Berne, 2.15 – 4.45 p.m.

http://www.aidsfocus.ch

Wien | The International AIDS Conference is the premier gathering for those working in the field of HIV, as well as policy makers, persons living with HIV and other individuals committed to ending the pandemic. It is a chance to assess where we are, evaluate recent scientific developments and lessons learnt, and collectively chart a course forward. Vienna, 18 to 23 July 2010.

http://www.aids2010.org

Partners: Afro-European Medical and Research Network, AIDS & Child, Bethlehem Mission Immensee, Caritas Switzerland, cinfo, CO-OPERAID, Déclaration de Berne, Doctors without Borders, Esperanza Medicines Foundation, FEPA, Fédération Genevoise de Coopération, Gemeinschaft St. Anna-Schwestern, HEKS, IAMANEH Switzerland, INTERTEAM, Kindernothilfe Schweiz, Kwa Wazee, medico international Switzerland, mediCuba-Suisse, missio, REPSSI, SolidarMed, Swiss Aids Care International, Swiss Aids Federation, missio, mission 21, Swiss Aids Care International, Swiss Catholic Lenten Fund, Swiss MIVA, Swiss Red Cross, Swiss Tropical Institute, Tear Fund, Terre des hommes Foundation, terre des hommes schweiz, and World Vision Switzerland.

http://www.aidsfocus.ch