Some time back we were corresponding, and you asked me to submit an article for Survival News. Our lives have changed dramatically since then, with our roles expanding way beyond our expectations (not that we were looking for bigger and better things!). So, here are some thoughts. . . .
Under a large leafy tree, with her daughter on her lap, Grace became one of a handful of people in Botswana to reveal her HIV status publicly. She was being interviewed by a South African Broadcasting Corporation reporter, who had come with her crew to witness the first grant given by Bristol-Myers Squibb to two small southern African AIDS organizations. ($100 million will be given to five countries in the region over the next five years.) As a beneficiary of the grant, the center where my husband Art and I work was chosen to host the occasion. We just wanted to get the grant and get on with the work, but no, this had to be a big function. Government ministers, local dignitaries and several hundred others joined us with dancing, singing and the inevitable speeches to accompany the hand-over of our first half-yearly payment of $71,800. Traditional food cooked in three-legged pots over an open fire for 700 to 800 people had been prepared -- it was a party!
We had come to Botswana in July last year, under the sponsorship of Mennonite Central Committee, to become coordinators of a small AIDS counseling center in Lobatse, southern Botswana. This center, called Tsholofelo Counselling Centre (Tsholofelo means "hope"), is the result of several years work by a dedicated AIDS activist, Edward Baralemwa, formerly working for many years with TASO of Uganda. Tsholofelo is one of four centers in the country under the leadership of the Botswana Christian AIDS Intervention Program (BOCAIP) which will benefit from the Bristol-Myers grant.
A small, financially struggling center, Tsholofelo has trained volunteer AIDS counselors providing service to people infected or affected by HIV/AIDS in the community. Denial, stigmatization and rejection are everyday occurrences for people daring to reveal that they are HIV+. For Grace to "come out" required tremendous courage, and now our job is to see that she is supported in her decision. We need many more Graces in Botswana. At present, of 13 trained counselors, only three or four work actively. More than 75 HIV+ clients have been helped in the past year at our center, many with pre- and post-test sessions, followed by ongoing counseling.
Why are we still struggling financially, after receiving our first half-yearly donation? These days, no one wants to donate to running costs. Orphan care, counseling programs, education -- all are more easily funded. At Tsholofelo, we have no money to pay a phone bill or buy toilet paper or tea. In the diamond-rich country of Botswana, AIDS funds are supposed to be available at district level to assist local CBOs, but little money filters through. We will have to find time to canvas local businesses for donations so the center can stay open.
The reality of AIDS in Botswana is so grim it is hard to grasp. In the main hospital in the capital city, Gaborone, 70% of beds in the pediatric ward are for children with complications of AIDS. The medical ward varies from 60-80%. Sometime this year, it is projected we will have 70,000 orphans, in a country with a population of 1.5 million people. One village of 30,000 people recently had 42 funerals in one weekend, with people having to choose whose funeral they would attend. Yet in that same village, a once-thriving orphan-care program struggles for funds, even for food for the children being cared for. One grandmother has lost all her siblings and their partners, leaving her with more than 20 young children to care for. This is in a society that used to care for its elderly within the extended family. True infection rates are closer to 30% (as reported in the January 17 issue of Newsweek), with most infections in the 15-49 age group. Life expectancy has dropped from 67 years to somewhere around 50 years, and is expected to drop as low as 40 years during the next ten years.
On a recent visit to the town of Maun, on the edge of the beautiful Okavango Delta in northwestern Botswana, we observed firsthand the reality of AIDS in Botswana, on a home visit with a counselor. An elderly mother, paralyzed from the waist down, sat right on the sand, dragging herself around. A primitive reed hut, with thatched roof and no door, was the only structure, with a pathetic attempt at more shelter built alongside the hut made up of torn plastic and tarps, without a roof. Five adult children and one toddler were living there and they were in desperate straits. One son and one daughter had been tested and were HIV+. Two young women looked as though they were in the end stages of AIDS. They lived on occasional piece work done by the son and were waiting for social welfare to raise their benefits so that they could buy more food. We were impressed by the dignity and determination of the young man -- who was very open to our visit -- to keep his family fed and clothed. He had collected enough pop cans (which are tossed down everywhere) to construct another house, and the counselor promised to find a volunteer crew to help him out.
Statistical studies show the rate of infection in pregnant women, particularly in northeastern Botswana, to be over 50%. This study, tracked by a CDC surveillance team, has shown the steady increase of infection in the last few years. Botswana and Zimbabwe vie for the highest infection rate in the world, with the rest of southern Africa not far behind. We struggle to know how best we can respond, with our limited manpower and resources. Because our national coordinator, Edward Baralemwa, has worked alone until recently, we have been asked to share our work week between our small center and the national office in the capital, Gaborone, an hour's drive away. My husband is the financial controller (with some bookkeeping experiences from our years in Zambia in the '80s), and I am now executive assistant, scary titles for people who came out to do grass roots work. But exciting, and a great challenge. Hopefully we can encourage and support more people like Grace.
H. Ruth Thiessen
30 January 2000
[Ed. Note: Ruth hails from British Columbia where she did community and church AIDS work for nine years before going to Africa. She and her husband, Art, first learned about AIDS during their stay in Zambia in the 1980s, a reality that hit very close to home when the father of their son's best friend died, in a home just around the corner from them in Lusaka.]