Tuesday October 23, 2018

HIV Outbreak In Southern and Eastern Africa

An estimated 800,000 people in eastern and southern Africa acquired HIV in 2017, and an estimated 380,000 people died of AIDS-related illness, the report indicated.

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More than half of the people surveyed who inject drugs said they avoided health-care services, citing discrimination or fear of law enforcement authorities.VOA
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A report by UNAIDS, “Miles to go—closing gaps, breaking barriers, righting injustices”, warns that the global response to HIV is at a critical point. Eastern and southern Africa remain the regions most affected by the HIV epidemic, accounting for 45 percent of the world’s HIV infections and 53 percent of people with HIV globally.

An estimated 800,000 people in eastern and southern Africa acquired HIV in 2017, and an estimated 380,000 people died of AIDS-related illness, the report indicated.

Mozambique, South Africa and Tanzania accounted for more than half of the new HIV infections and deaths from AIDS-related illness in the region last year.

The survey also indicated that there was discrimination against HIV positive persons in healthcare settings, especially towards key populations.

Key populations include men who have sex with men, drugs users, transgender persons and sex workers, considered to be most at risk at contracting HIV.

There are nearly 1 million sex workers estimated to need services in the region.

“For us it is important in fact we do have within NASCOP, a key population program, mainly targeting the key populations, the female sex workers, men who have sex with men and injecting drug users,” said Dr. Kigen Barmasai, the director at Kenya’s National Aids and STI Control Program, NASCOP “One, we know that this contributes to 33 percent of new infections in Kenya, from this key populations, of course the prevalence varies, we have prevalence from 29 percent in female sex workers to 18 percent among the injected drug users. So as a program we are working on this and we are spearheading the HIV prevention, treatment and care efforts to reverse the epidemic. For the last ten years we have been working on that.”

More than half of the people surveyed who inject drugs said they avoided health-care services, citing discrimination or fear of law enforcement authorities.

HIV
The survey also indicated that there was discrimination against HIV positive persons in healthcare settings, especially towards key populations..VOA

In Kenya homosexuality is illegal and being found guilty can lead to a sentence of up to 14 years in prison. Sex work is also illegal in Kenya.

“The criminal nature of Key populations, and the acts of Key populations that make people shy away from accessing health care and even organizing, coming together so that they can organize,” said Grace Kamau, chairperson of the Key population consortium in Kenya. “The main thing is the criminal nature. People fear to be arrested”

The report said about two-thirds of all people living with HIV in the region were accessing antiretroviral therapy in 2017.

Kamau attributes the successes in reaching large numbers of Key populations in Kenya to availability of HIV resources made possible by donor funding, but she says more people are yet to be reached.

“One of the things we have in Kenya is private clinics that are donor funded,” said Kamau. “That is where the sex workers feel comfortable and that is where they access their services. And that is what has made the number to go high.”

The report indicates that there were 19.6 million people living with HIV in eastern and southern Africa at the end of 2017.

Out of this number 81% were aware of their HIV status, an increase from 77% in 2016.

West and central Africa continues to lag behind as statistics indicated AIDS-related deaths have fallen by only 24% in western and central Africa, compared to a 42% decline in eastern and southern Africa.

Also Read-UNAIDS : World Is At A “Defining Moment” In A Battle Against HIV/AIDS

Nigeria has more than half of the HIV burden in the region and there has been little progress in reducing new HIV infections there in recent years. (VOA)

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The Tale Of Dying Dreams In The Name Of Tradition

Tony Mwebia of the Men End FGM campaign said visits to primary schools show that even as early as age 10, there are far fewer girls than boys.

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Maasai girls and a man watch a video on a mobile phone prior to the start of a social event advocating against harmful practices such as female genital mutilation at the Imbirikani Girls High School in Imbirikani, Kenya. VOA

It was during her first year of high school in rural western Kenya that Mary Kuket says she was “sacrificed to tradition” and her dreams of becoming a doctor shattered forever.

With no explanation, the 15-year-old was given away to another family, who forced her to undergo female genital mutilation (FGM), then married her off to their middle-aged son.

“I kept asking my parents why I was being taken and begged them not to send me away, but my father pushed me away, saying that soon I would understand,” Kuket, now 46, told the Thomson Reuters Foundation by phone from Baringo county. “They never told me I was going to be cut. They never told me I was going to be married to a 45-year-old man. They never told me that I would not go back to school.”

From the fear of being ostracized or killed to the prestige associated with entering womanhood, girls in Kenya are under a barrage of societal pressures to undergo FGM, often with a devastating impact on their education, say campaigners.

Female Genital Mutilation, FGM
A badge reads “The power of labor against FGM” is seen on a volunteer during a conference on International Day of Zero Tolerance for Female Genital Mutilation (FGM) in Cairo, Egypt,(VOA)

A study by the charity ActionAid Kenya published Monday said despite the fact that FGM is illegal in the east African nation, deep-rooted myths supporting the ancient ritual persist.

Violence ‘normalized’

The survey, based on interviews with almost 400 girls and women in eight Kenyan counties, found that FGM affected not only their health but also their schooling.

“Despite efforts to curb FGM, this type of violence against women and girls is so normalized in some communities. Girls are socialized into believing they must undergo the procedure,” said Agnes Kola, women’s rights coordinator for ActionAid Kenya. “But it is stifling their ability to participate in society, as once they undergo FGM, their schooling is impacted and many never complete their education and progress in life.”

Girls missed school to recover after the procedure and suffered medical complications and trauma that affected their class attendance and performance, the report said.

Female Genital Mutilation, FGM
Students arrive at the start of a social event advocating against harmful practices such as female genital mutilation at the Imbirikani Girls High School in Imbirikani, Kenya. VOA

Seen as a rite of passage in many communities, FGM also acted as a trigger for girls as young as 11 to become sexually active and married off as they were perceived as women — often ending with child pregnancy.

As a result, fewer girls than boys in Kenya’s FGM-prevalent counties were finishing their primary education, and even fewer were transitioning to high school, the study said.

While national figures show secondary enrollment of boys and girls in year one to be almost equal, in some FGM-prevalent counties, enrollment of girls in the same group is less than half that of boys, according to government data.

‘Ticket for marriage’

An estimated 200 million girls and women worldwide have undergone FGM, which usually involves the partial or total removal of the genitalia, the United Nations says.

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Girls sit in the yard at Kalas Girls Primary School, Amudat District, Karamoja, Uganda, Jan. 31, 2018. They each escaped home after their families tried to force them to undergo FGM or to enter into marriage. VOA

Despite being internationally condemned, it is practiced in at least 27 African countries and parts of Asia and the Middle East, and is usually carried out by traditional cutters, often with unsterilized blades or knives.

In some cases, girls can bleed to death or die from infections. FGM can also cause lifelong painful conditions such as fistula as well as fatal childbirth complications.

Kenya outlawed the practice in 2011, but it continues as communities believe it is necessary for social acceptance and increasing their daughters’ marriage prospects.

One in five females aged 15 to 49 in Kenya has undergone FGM, according to U.N. data.

The study in eight counties found fear of being rejected for marriage, ostracized by the community or even killed was pushing girls to undergo FGM.

In the eastern county of Garissa, Muslim communities were cited as saying anyone who was not circumcised was not permitted to worship and could easily be killed.

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Amran Mahamood used to circumcise young girls in Hargeysa, Somalia, but stopped after a religious leader convinced her the rite was not required by Islamic law. VOA

“Religiously, we are told that circumcision makes girls to be clean before God, and it is only after undergoing this practice that the girls can be allowed to read the Quran or to worship,” said a woman from Garissa, cited in the report.

Elsewhere, girls and women said they were expected to undergo FGM to comply with cultural expectations of marriage.

“FGM is considered as the community-given ticket for marriage, thus it results in automatic suitors or bidders, which is absolutely the parent’s choice,” said the report. “Young men will ensure their wives get circumcised at the time of marriage.”

Progress hindered

Soon after being cut, the girls, who are drawn from communities in which up to 98 percent of women and girls have undergone FGM, said they struggled to continue with school.

They were absent for weeks to heal and also suffered infections and trauma, according to the report.

Female Genital Mutilation, FGM
 A Masaai villager displays the traditional blade used to circumcise young girls August 12, 2007 in Kameli, Kenya. Maasai are a pastoral group mostly clustered in the Rift Valley. They practice circumcision on both boys and girls during puberty years as a rite of passage to adulthood. 

The practice also provides social sanction for girls to be married off or have sex, often resulting in pregnancy.

Tony Mwebia of the Men End FGM campaign said visits to primary schools show that even as early as age 10, there are far fewer girls than boys. “Sometimes it’s just one or two girls compared to a whole lot of boys,” he said.

Campaigners said government and civil society had neglected remote, insecure regions where FGM was most prevalent. They called for specific budgets to be allocated to these areas, using positive messaging to engage with communities, and for better coordination between charities.

For Kuket, however, all is not lost.

After 20 years of marriage and seven children, she went back to school, finished her secondary education and has enrolled to work toward a degree in community development.

Also Read: ‘The Restorers’: Kenyan Girls Use Technology to Combat Female Genital Mutilation

She is also a prominent human rights activist in her community in western Tangulbei, where she rescues girls who are being forced to undergo FGM and pushed into child marriage.

“I don’t want any other girl to go through what I did,” she said. “FGM is a barrier to a girl’s progress in life — it ruins their lives.” (VOA)