...
written by aeichener , February 23, 2007

Excellent and thoughtful article, except for one paragraph that could have been written by Tony Mochama, Paddy Ahenda or Lucy Oriang'.

But as to the rest: sincere compliments!

Alexander

Not necessarily true.
written by Honey , February 23, 2007

I possibly missed the point.

Your second paragraph claims that the racial notion is non-scientific, I differ. However, I do not look at it like the a caucasian thing vs. a negro thing. Biologically (I will stay away from the lingo, because my reply is in a relaxed mood, not a paper-writing thing) there is a slight difference in the HIV receptors in negro people. It is a plain scientific fact, but we are so embroiled in being socially corect, we are doing ourself a diservice.

Fact: Only black people suffer sickle cell amnaemia.
Fact: Only white people suffer Lou Gherig's disease.
Fact: Jews have shown more prevalence for Tay-Sach's condition.

It is not hating, it is just the way it is, until some one finds out why?. Is that a race issue?

From the West? Accepted.
written by Honey , February 23, 2007

And so the word had to come from the West to be beleived.

According to CNN, (they are calling it a break through in Science) circumcision can reduce HIV contraction upto 60%. They are now working on rooting it in the places that suffer the epidemic.

Cool.

...
written by emmo opoti , February 23, 2007

There is as yet no proved link between HIV and race.

1 in every 9 people with HIV is an Indian, there are far fewer people with HIV in Nyeri than there are in Mbita. There are also millions of Chinese people with AIDS.

Well.
written by Honey , February 23, 2007

:shock: I am unable to quote the papers published on the case (simply because it is a tiring effort) but we can leave it as it is and continue with our safe-living.

The point is, the race thing in HIV should be looked at largely as a study issue or other things, not prejudice and hating.
The fear to offend (politikal corectness) by many people keeps them off from helping where they could.

Communication is not a science. Most geeks may not know how to say things in the 'correct way'.

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written by a guest , February 23, 2007

Misology at best. Good Lord.

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written by Bosibori , February 24, 2007

Excellent Article Stephen !very well expressed.

On the other hand I side with Honey, while nutrition is an important element in immune boosting,the the high AIDS rates in African Americans downplays nutrition as a major cause for AIDS transmission.They (African Americans )who have equally good nutritional values as their corresponding Caucasian population.Here in America AIDS is the leading cause of death in African American women.The same scenario repeats itself in Africa .

...
written by Stephen Wanyama , February 27, 2007

Fact: Only black people suffer sickle cell amnaemia.
Fact: Only white people suffer Lou Gherig's disease.
Fact: Jews have shown more prevalence for Tay-Sach's condition.

So much for facts.
This article is about preponderances to HIV-infection. If you knew anything of the epidemiology of HIV-AIDs in Africa. It specifically sites the fact that poor nutrition, poor medical care, poor hygiene,etc are co-factors in the high HIV prevalence rates in Africa.

Sickle cell anaemia is a mostly West African phenomenon. Its incidence in East and Southern Africa is not too different than the numbers for other malaria prone areas like India.

Regarding the conditions you mention above, even a cursory look at their etiologies shows how different they are from HIV-AIDs. I guess next you will be telling us that black people have a genetic propensity to catch malaria?

HIV/AIDs is not a genetic condition!

Well Mr. Wanyama.
written by Honey , February 27, 2007

If you say so. I will leave it at your conclusion. I know nothing about HIV, and will not be knowing in the future.
Let Africans take care of it. Am in America.

It is true that a negro is most likely to 'catch' the virus at the first exposure as opposed to a caucasian. Am not sure it has anything to do with huge phalluses or such non-issues.

My quoting of the genetic conditions was to simply drive home the point: Sometimes what one is crying for may not be what they need!

I rest my case. Race is out of this, it is even racist to look at it that way. :wink:

re:
written by emmo opoti , February 27, 2007

the the high AIDS rates in African Americans downplays nutrition as a major cause for AIDS transmission.They (African Americans )who have equally good nutritional values as their corresponding Caucasian population.

Actually African-Americans, especially the ones catching all the HIV-AIDs are among the most vulnerable of all Americans.
Over-worked, poorly fed and with poor medical care. Remember 45 million Americans live without basic health insurance. This also explains why Eastern Europe has so much HIV than Western Europe, and partially explain why people like drug addicts have a higher propensity to be infected.

AIDs really has absolutely nothing to do with race, why else are prevalence rates lower in the Gusii Highlands than they are in Mbita? Why are they higher in Thika than in Othaya?

However, I disagree with Wanyama on one issue. Behaviour is a factor, maybe not the main one but still a large factor. There is almost no HIV in Pakistan, and plenty in India. Also compare North Eastern Kenya with the rest of the country, the part with the poorest medical care, poorest nutrition, etc and still very low prevalence rates.

Aids and \'Blacks\'
written by Marangu , February 28, 2007

Bw Wanyama, I thank you for raising this issue, how interesting that people buy the notion that Aids as a pandemic finds a specific dynamic that increases its prevalence among Dark skinned people. There is no scientific evidence to support the race issue at least thus far. Historically more people of caucasian origin died from the plague than any other race - any suggestion of the affinity of this 'super' race to the rats (the intermediate host for plague)could land you in enough trouble today.
That HIV/Aids has cleared alot of Africa's productive population is not in question. To narrow the explanation of HIV aetiology to a genetic or racial factor is rather simple self defeating to efforts to combat the spread because we can then assume its a phenomena we can do little about.
Honey has a point only in as far as the prevalence of some diseases is geographical nay racial, hence the recent outbreak of bird flu had a lot to do with where if first occurred and not the Asian population. Luckily sound epidemiological knowledge and strategies helped to curb the spread. The logical steps to containing any viral or infectious disease lies in understanding the disease itself, its mode of spread. Much of Europe and a number of Asian Pacific countries have confined HIV/Aids to the populations where it was first detected, mainly by empowering those people not only with easy access to Anti-retroviral drugs but also with the responsiblity to educate their peers and the general public.
What we have had in Africa from the powerful drug companies, the Western media companies and their mouthpieces in Africa is perpetuation of a myth that serves their interests, how sad that some contributors here buy the same.
While Mr Mbeki and his health minister have a point, an alternative explanation of HIV/Aids causation is not what is required, this undermines the efforts to fight the diseases and South Africa is a good example. We need a total appreciation of the danger Africa faces from this disease and employ all means available. In my mind this is probably the worst enemy Africa has faced since colonialism.
As for those who think of circumcision as some form of insurance, stay circumcised but stay safe, and check on the current HIV/Aids incidence and prevalence statistics, lest you fool yourselves.

Thanks Mr. Marangu
written by Honey , March 01, 2007

In as much as I appreciate your post, I fail to see any pointed solutions that may help Africa and its people. The generalized ideas above have been in play since the 80's, nothing has changed. Don't we think, there has to be something we are missing?

I will say one thing: Out of the 20 drug therapies available for HIV carriers, people in Africa do not have a choice on how to combine this concoctions. In the west, they do.
How does it affect us? The truth is, each combo of drug therapy has its cons and pros. Certain groups of people work better with certain combinations, others dont. Out here, a woman with a T-cell count of 4, and a viral load in its millions, can easily bounce back in about 3 months to the magic 1000 T-cell count, in Africa, it is a death sentence. I find it hard to beleive that very many people would understand all that jargon (c'mon, Kenyans/Africans are not very literate). That is why finding a cause and eliminating it will serve Africa best. Alternatively, please translate this things in native languages, and call them what they truly are. Not crocodiles and mdudus My opinion.

One issue that eludes my understanding is the common association of race with negativity. I think it stems from the an embedded beleive that 'negro' is inferior hence the often dash to the defensive any time the word comes up, before even digesting the issue at hand.
It reminds me of Mark Twain's book 'Huckleberry Finn' that was banned from schools for along time, because it had 'N' words in it.
Not to digress.

In your last paragraph, your approach of tackling the disease (as is today) is a wild goose chase. We appreciate the dangers, and keep 'watering' the roots.

I think Mbeki is right, find the cause, and eliminate it. Until then, we are at its mercy. This will not stop people from perishing, whicheverway, it will kill us. We muct find the stregnth to overlook the deaths and find a lasting solution.

Of circumscision: There is a simple mechanism called 'proactive measures'
If a man cannot be monogamous, can barely remember protection every time, it is only common sense to take actions that will protect him. The same way, after an accident, one takes action to prevent further damage.

My friends, until we start seeing things for truly what they are, instead of confusing non-issues and real issues, we are doomed.

HIV/Aids - The issues
written by Marangu , March 01, 2007

Honey, appreciate your comments. It would be fantastic if we could, on this forum, outline a blueprint that will lead to Kenya/Africa free of HIV/Aids.And if that worked, we could replicate the same in cleansing ourselves of the rampant infectious diseases, deficiency diseases and parasitic infections which singularly anyway account for higher morbidity and mortality compared to HIV/Aids especially in Sub-Saharan Africa.
My argument therefore, is we cannot isolate a disease, set up programs to eradicate it and hope to succeed when generally we lack essential health infrastructure and relevant legislation to support it. The disease in question happens to be one that requires robust health infrastucture to deal with its myriad syndromes.
Some areas in need of urgent attention if we can expect to put a dent to the current pandemic:
-Curb corruption in all sectors
-Relevant Legislation (weed out all those illegal clinics, pharmacies etc)
-Health maintainance Organisations(Give meaning to the NHIF Card in Kenya)
-Address equity issues (to ensure diagnosis and treatment is available equally to those in Westlands and Ikolomani)
-Education, education, education (in all shapes and forms)
Again, I can see no benefit in dwelling on what 'exactly' causes it, how it is 'exactly' spread.. ad infinitum. There is enough evidence (scientific) out there on the many ways you can contract HIV and the many ways you can protect yourself. If you think Circumcision is the route, go ahead. But there is so much more and easier ways to protect yourself. At least we are talking about it, thats a good starting point.

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written by aeichener , March 01, 2007

Excellent and precise comment, Marangu, thank you !

Alexander

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written by Stephen Wanyama , March 01, 2007

Marangu,
That was exactly the thrust of my comment. It is all well and good to tell people to abstain, to be faithful and to use condoms, but if these people are already suffering from poor hygiene conditions, a lack of drugs for the slightest health conditions, chronic malnutrition, chronic stress and the incessant assailment of their bodies by parasites then these preventative measures do not address the whole picture.

Honey,
Your comment on T-cell counts, viral loads and drug combinations is further proof that there needs to be a wholesale effort to address the inadequacies of our healthcare system.

Aeichener,
What paragraph was Oriang'esque? That was not a helpful comment at all.

Viscious cycle
written by Honey , March 01, 2007

One thing we must all agree on is that AIDS is largely aided by a lack of sound management from all sectors, private and govt, and also feeds on poverty.

All you mention Mr. Marangu & Wanyama is true.
Unfortunately, it is utopic to most Kenyans. Don't you think so?.

I probably are pessimistic when it comes to Kenyan governance (or Africa), in that, I do not see any of the above mentioned happen soon.
Even if leadership was to change hands today, I dont see any one deliver the abracadabra goodies.

Bad governance, Poverty, and Corruption are cancers in Africa, whose remission is not in the near future.

By the way, my view on AIDS is totally out of touch with most people. I do not give much thought to the ending of life, (after all, we all must die) what worries me most is the overall effect to a family, nation or continent. It has replaced slavery. The continent's young and able are perishing, its economy on its knees. It is certainly draining Africa, slowly but surely.
For those who will be offended by my insensitivity,apologies.

At this point, I must say that if circumcision of the phallus reduces chances of transmission, it has to be looked into. This is not time to deviate into our tribal mediocrity.
It is simply a health issue,and Africans must fight with what they have.

It costs money to do research and produce drugs. No one is willing to do charity work for Africa.

WE MUST WORK WITH WHAT WE HAVE?
Beggers can not be choosers.

...
written by Marangu , March 02, 2007

Very useful insights everyone.
Stephen and Alex :
I think there is so much to be gained by having debates like this one, the truth is to impact on the current policy and misdeeds, we need to talk about them. Right now a number of people within Wizara ya Afya will be following this discussion, and it would be nice to hear their views as the foot soldiers. We need a Afya Corner, to keep these debates alive.
Honey:
Largely agree with your sentiments but actually your position on circumcion is rather mythical, while its largely acknowledged that its beneficial, scientifically it has never been mooted as a preventative strategy. And those from circumcising communities have lost as many of their loved ones as those from non-circumcising communities to HIV/Aids.

Not preventive, proactive.
written by Honey , March 02, 2007

I am afraid I will have to dissect the circumcision issue further.
Understanding what I am talking about will require that you restrict your reasoning to HIV and transmission, not any other reasons people go for the act (manhood yada yada...NO. FYI I have been in love with folk from uncutting communities all my life, they are super).

Without stretching our heads, lets say two women, one on her menses has an HIV encounter (of course sexually) and another not on the cycle. Who has the probability of catching the virus on first encounter? The one in the menses cycle, simply because her membranes are more susceptible to fluids. The phallus in uncut men (this has been said again and again) is more traumatised in copulation, increasing its vulnerability to transmision.
I also assume that exposed phalluses tend to have tougher (a scab or something) as opposed to unexposed ones.
Even Alex, the admin knows that one.

It is not bullet proof help, just a small way of fighting HIV with what we have, and can afford.
And surely, even if the help is under debate, what is there to loose?

Ongeza hapo na kukula maembe, mapera, machungwa, payapaya and lots of proteins, kunywa maziwa kabisa.
If we follow this simple aids, we can make this chronic illness very manageable.

...
written by Marangu , March 02, 2007

Honey:
You are preaching to the converted here, I much rather go with your closing remark than your pre-occupation with phallus, and the cut etc
Ever wondered how much of the world practice this ritual? Have you checked HIV prevalence figures lately, plot in your grobal map those who cut and those that do not, do the same for HIV Morbidity and see if that helps your argument.
I know so many that have contracted this disease without the 'turban' that I think you setiments could mislead some more.

Converted
written by Honey , March 03, 2007

Marangu:
Whatever that means? I know not. If you are a medical doctor, I hope you know the truth.

I think Africa has simple solutions to its problems than the complexities that we like to think we can use, when we truly can not, and have no understanding of.

Pre-occupation with phallus? I take offence in that statement. Moreso, the phallus is largely responsible for spread in Africa, especially in heterosexual r-ships. If saliva swapping caused as much 'havoc', I think there'd be more of kissing talk. I am not even where you are Marangu.

Statistics, I don't get stuck on numbers. I interview/talk to the people who are with it, worked with those with it, and live with it. Half the time, I disregard the stats, because they are a false projection.

The cut issue was again in the medical journals last month as afactor for prevention, after being discredited some 3 or 2 years ago. Of course the medical fraternity still debate it, the whole proffesion is a practise.
For something that has no known disadvantages, and is thought to have advantages, why fight it.

...
written by Marangu , March 03, 2007

Ok:
I will take back the comment that you are preoccupied with the 'cut' issue.
Can we ignore statistics? I very much doubt that, statistics inform the strategy we use. And if the cure for HIV is to be found in science, lord behold if statistics have no place in deciding how to about dealing with it.

AIDS and Poverty in Bangladesh
written by Mohammad Khairul Alam , April 19, 2007

AIDS and Poverty in Bangladesh

Mohammad Khairul Alam
Executive Director
Rainbow Nari O Shishu Kallyan Foundation
24/3 M. C. Roy Lane
Dhaka-1211, Bangladesh
This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Tel: 880-2-8628908
Mobile: 01711344997



AIDS pandemic is already having destroyed social and economical system in some regions of South African countries. It makes threat to move backward the progress that economies have made in many poor countries. HIV/AIDS affects everyone in both developed and poor countries. It is not a disease of poverty. It is not individual problem. However the pandemic does push people deeper into poverty, making it more difficult for them to sustain or recover their earlier livelihoods. That, in turn, can make people and their families more vulnerable to HIV/AIDS infection. Globally, every day 14,000 people getting infected HIV and among them 90% of less developed countries.

Poverty does not cause HIV/AIDS infection; it can facilitate transmission, Poverty makes people more vulnerable to HIV infection, due to lack of health care knowledge, lack of proper digest, and lack of sufficient nutrition, which can result in a weaker immune system. They also have less access to healthcare facilities and education on health issues such as HIV prevention. So it is fact, poverty & gender discrimination would be the main cause of the spread of AIDS in Bangladesh, The rate of vulnerability to HIV/AIDS is our country is higher then the many parts of the world. Unfortunately we are bound to say, HIV is only transmitted through man. We don’t get infect it by other living or death species. The overwhelming majority of people infected with HIV do not know they carry the virus. Many millions more know nothing or too little about HIV/AIDS to protect themselves against it. So it is true that men destroy themselves and others.

The most common reason of HIV/AIDS is considered to be the unsafe or unprotected sex. Sex without taking proper precaution like condom is very much responsible for HIV/AIDS. AIDS is usually transmitted from man to man through the semen or blood. Since 1981, more than 60 million people have been infected by HIV of which over 22 million people already died. Now, over 50 million people are living with HIV.

The health care system is low in Bangladesh. Thousands of people die in every year by several seasonal diseases. Particular health care or prevention knowledge would prevent this fatal mortality. Capital city’s health care system is upgraded in some extent but rural level health care system is nominal. Several NGO’s are working on HIV/AIDS prevention sector. But we found that there is a massive need of facilities and manpower to deliver comprehensive HIV care and laboratory facilities to support and monitor the therapy. There is a similar lack of medical personnel with enough knowledge of antiretroviral therapy. Possibilities for drug distribution to remote corners are limited and storage facilities are often insufficient.

Rainbow Nari O Shishu Kallyan Foundation found extremely high levels of infections among adolescent girls, which are higher than those for boys. This is mainly because of the fact that at young age, boys have sex with girls of similar age, while girls have relations with older men, who are more likely to be infected. Sexual harassment of schoolgirls by older men sometime may be the cause of HIV infection. Poverty also drives many adolescent girls to accept relationships with 'sugar daddies' (older men who are prepared to give money, goods or favors in return for sex).

As mention AIDS Researcher Mr. Roger Tatoud, “To "think" about women and their role in society is already to empower them. It is the first step that leads to power-sharing between men and women, and as such should be at the heart of the responsible and hopefully successful strategies much needed in the fight against HIV and Aids. Undoubtedly gender mainstreaming requires political will and commitment, often in the hands of men.”

Since the join and traditional familitical system playing a vital role to prevent HIV/AIDS without our concern in Bangladesh, this disease is not turning into an epidemic in a poor and illiterate country like us. Our religious belief, respect to other people’s thought, politeness as a nation and restricted social system etc. and the education which we get from our families, are protecting us from many unsocial activities and bad jobs. But in these days, our social values and the social structure are facing a great threat following the western cultures. Familitical ties are breaking; pre-marital relation and unsocial activities are increasing day by day. That is why to protect the traditional social system and to make aware the people – we have to be alert.


Reference: World Bank, UNAIDS