The Highest HIV Rate in the World: Beyond Statistics #1

Swaziland has the highest HIV rate in the world, with estimates of the adult prevalence rate ranging from 26%-38%. Before I left for BarCamp Swaziland, in between buying batteries and packing tripods and making sure I had enough DV tapes, I needed to try to wrap my mind around this reality. What did it really mean to live in a country so devastated by HIV?  I wanted to know why the rate was so high.

I read an audit of HIV/AIDS policies in Swaziland funded by the WK Kellogg Foundation. On page 12, it listed factors fueling the epidemic in Southern Africa. Economic and civil war-induced migration, especially migration to work in gold and platinum mines in Botswana and South Africa, is a key factor in spreading disease. Unsafe sex and multiple partners remain a common cause of infection, as are dirty needles and poor health delivery systems.

Phindile, a smiling, broad-faced young woman with close-cropped hair, is the oldest one on her rural homestead and helps to care for her siblings. Her parents have both died. An older brother works in the city and sends money “sometimes.” As an advisor to YouthAssets.org, Phindile helps to counsel other orphans who head households. Largely due to the AIDS epidemic, there are over 15,000 orphan-headed households in the small kingdom of Swaziland, about 10% of families.  

We interview her in Hluti, a rural village near the South African border,  on a red-dirt path shared by cows and goats in front of her school. Many Hluti men cross the border to work in South African mines, where many prostitutes are HIV positive. Phindile clutches a notebook close to her chest in a shy girlish way, faded paper cutouts of women in haute couture dresses pasted to the cover. 

“What do you want to be when you grow up?” we ask.

She hesitates, as if we are assuming too much, and then says, “A businesswoman,” her sparkling smile illuminating her cheeks.

“Do you take care of your siblings?” we ask. It seems both a kind acknowledgement and a cruelty to ask that.

“Yes,” she answers, her mouth tightening, looking down.

“Does anyone help you? The neighbors?”

A pause. She looks at the ground. “No. My brother…sometimes.”

Her mouth forms “sometimes” in the way someone would say “rarely”, and as she says it a wave of realization of her loss washes over me.

Phindile’s smile fades for a brief moment, and she confides, softly: “Life…is miserable.”

And then she continues, her confidence and optimism returning, speaking with a steely gaze. “Girls need to stay in school…they shouldn’t just chase money…they need to be educated.”

The way she says chase money makes me realize something else – the factor of poverty fueling disease includes sex to pay the bills. I am hoping Phindile stays in school, that she can stay in school. Her hands clutch her notebook tightly, close to her chest, as if it is her anchor.

Category: Africa, Swaziland | Tags: , , , , , 83 comments »

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