Thursday, June 16, 2011

Red Moon Rising

On June 15, there was a rare full lunar eclipse that could be seen by most people in the Southern Hemisphere. I have never seen a lunar eclipse before and it was wild to sit and watch a shadow come over the moon. Once the moon was in the earth's shadow, it was very dim and had a faint red color.

I took about 50 photos but my camera just really isn't up to the task of taking good shots of the moon. The three pictures I posted are the best I took.

The next full lunar eclipse will be on July 27, 2018 but also will only be visible in the Southern Hemisphere.

Tuesday, June 14, 2011

Civil Service Workers Strike in Botswana

Shortly before Easter, the union that represents over 100,000 civil service and government employees went on strike seeking an increase in their salaries. The strike was originally intended to last 10 days and was billed by some as the "Mother of All Strikes." The workers marched from the office of local government to the offices of the city government to deliver their petition and then sang a few songs.

Across the country over 90,000 workers went on strike and the many government services were unavailable. Many clinics here and the main hospital operated with skeleton staffs, effectively closing them.

I didn't quite know what to expect but life continued pretty much the same as it always had in the days following the announcement. The only major annoyance was that the woman who is in charge of the government stockpiles of condoms went on strike and I couldn't get condoms for my prevention project. Everything remained peaceful and the striking workers all congregated on a nearby soccer field and sang hymns.

The original 10 days passed and neither side could come to terms. The union declared that the strike would then be indefinite and it continued. Then, in May there started to be scattered reports of violence. Botswana is a relatively small country, rife with rumors, and there was a lot of misinformation. There was a small riot by students in the southern part of the country and there were some other small scattered events like burning tires in the road in other parts of the country. After the riot by students the government closed all school in the country (the teachers have been on strike but the students were expected to report to class every day).

Things still were quiet here in Francistown until this past week. (I was on vacation and wasn't in town). Apparently, some strikers became upset and started burning tires in the main traffic circle and then started to march into town. In the video below, you can see that the police arrived, fired tear gas, and the crowd dispersed quickly. There was some property damage and a few injuries, but nothing major happened.

That one day was the extent of things. On Monday, the union called off the strike and most workers here went back to work.

Also, here is a picture gallery of the strike around the country:

I have never felt unsafe or scared to be here and nothing that happened with the strike has changed that. Botswana remains a very peaceful country I am thankful the strike did not escalate.

Wednesday, June 1, 2011

Why Is There So Much HIV In Botswana?

As a caveat: this is strictly my opinion based on my personal experience and research. I am by no means an expert, much less a scientist.

If you Google “HIV rates in the world”, you might get a map of the world that is a patchwork of colors. Look closer and you will find that the southern Africa region is home to the highest rates of HIV in the world. In fact, if you look at the countries with the highest rates of HIV, 9 out of the top 10 are in southern Africa and all are in Africa. The continent has only 15% of the world’s population but has almost 90% of the HIV cases.

Botswana’s current HIV rate is somewhere between 20 and 25%, giving it the dubious position of the second highest in the world (only behind Swaziland).

The question “Why is there so much HIV in Botswana?” is deceptively simple with no simple answer. In short, people here contract HIV because they have unprotected sex with someone who is not their exclusive, life-long partner. While this fact is very true, it does little to explain the current epidemic. Many people in countries all over the world, including the United States, have unprotected sex with someone who is not their exclusive, life-long partner but it does not lead to high HIV rates. In fact, in the United States the HIV rate has never exceeded 1%.

So there must be something else that drives the epidemic here, but what exactly is it? I recently did an informal survey among the peer educators I work with and asked them to give me their opinion of why there is so much HIV in Botswana. The answers were all over the board but included causes such as poverty, ignorance, prostitution, low or incorrect condom use, and multiple partners.

The International HIV/AIDS charity Avert lists the causes as, “poverty, economic disparity, social instability, gender inequality, sexual violence, other sexually transmitted infections (which facilitate HIV transmission), lack of male circumcision, high mobility, rapid urbanization and modernization, and ineffective leadership during critical periods in the epidemic’s spread.

I think it is safe to say that the cause is quite complicated. The above issues definitely play a part in the spread of HIV, but taken individually, few can completely account for the epidemic. There are plenty of poor countries that have HIV rates below 1%. There are also many countries with lots of prostitution with low HIV rates. There are also many countries that have both very low condom use and low levels of HIV. So what makes these countries different from the ones in southern Africa?

A few issues stand out as most important to me and they form a "lethal cocktail". The region has very low levels of circumcision, high rates of STIs, and has the practice of multiple concurrent partners (MCP). (Interestingly enough, tribes in southern Africa practiced circumcision as part of a male rite of passage ceremony for centuries, but the practice was thought to be "barbaric" by early missionaries and was consequently stopped). Currently, the Government of Botswana is making a large push to get men to get circumcised.

MCP is particularly dangerous because HIV is highly contagious in the first 3 months of infection and can easily be passed on to many people in a sexual network. It is also deeply engrained in the culture. There is a phrase in Setswana that translates to, “A man cannot be contained to one kraal” (A kraal is a stable for cattle) and I have heard that there is no direct translation for the word “fidelity.” A recent study by the CDC in Botswana showed that up to 33% of men in Botswana engage in MCP, while it was around 25% for women. Studies also show that couples in long term relationships are less likely to use condoms than those who engage in casual sex, further exacerbating the problem.

In her book “The Invisible Cure,” epidemiologist Helen Epstein, theorizes that the main reason there is a much higher HIV rate in southern Africa than the rest of the world is primarily due to MCP and has the opinion that this cultural aspect is a direct driver of the disease (An opinion I absolutely agree with). She also shows that there is evidence that if you only lower the number of concurrent sexual patterns, the HIV rate will drop significantly. All you have to do is look at the ABC campaign in Uganda during the 1990's that stressed partner reduction and condom usage. This highly successful campaign resulted in a drop in the HIV rate while it was skyrocketing in most other African countries.

Western culture in general does not tolerate MCP and this is a major reason the rest of the world has been spared from HIV spreading through the general population. It is easy for a "westerner" to sit back and make moral judgments. There is a still a large problem with a morality based stigma associated with HIV. Because HIV is primarily caused by sex, and sex raises all sorts of moral and religious issues, it is easy (but incorrect) to think that a person with HIV has done something wrong. The problem with MCP is that it exposes a large number of people to the disease through vast sexual networks, especially if a person's partner is not completely faithful.
The causes of HIV in Africa, and especially in southern Africa, can seem quite complicated and difficult to change, but HIV remains a disease that is easily prevented. What remains to be seen is if people and governments have the willpower and the courage to motivate themselves and others to change their behaviors.