Namibia’s health officials are grappling with the magnitude of the HIV/Aids pandemic in the Caprivi Strip, which borders three of the world’s worst-affected countries — Zambia, Zimbabwe and Botswana.
The HIV prevalence rate among pregnant women in the Caprivi region stands at 43%, much higher than that of the entire country’s 22,5%, according to a 2002 Ministry of Health and Social Services report.
As a result, the government has stepped up its life-prolonging anti-retroviral drugs programme in the region. It has also prioritised the prevention of mother-to-child transmission, as well as the implementation of a cluster of programmes aimed at creating awareness about HIV/Aids and fighting stigma in the Caprivi.
“Clearly, we have a very serious situation in the Caprivi region,” said Norbert Forster, undersecretary at the Ministry of Health and Social Services. “There is still considerable denial of the presence of HIV/Aids in the region. Many people in that area believe that the large numbers of deaths are occurring due to witchcraft and that is a very big problem for us.”
Kanku Ndalambo, a medical doctor at Katima-Mulilo hospital, the biggest in the Caprivi, shares Foster’s view.
“The problem here is cultural. The people’s first reaction, when they fall sick, is to go to the traditional healers where they get tattoos and cuts with razor blades and other instruments that might not even have been sterilised. They come to us only when they are really sick,” he explained.
The hospital, he said, is running workshops for traditional healers and leaders in a bid to increase their awareness about the disease and prevention methods.
Ndalambo said the men in the Caprivi Strip are not as keen as women to come for voluntary testing and counselling.
Of the 400 people who have been tested at the Katima-Mulilo hospital since December last year, only about 100 are men, according to Ndalambo.
“Men still have power over the women who are, in most cases, economically dependent on their men. Men here threaten their wives with divorce or simply abandon them if they see them coming to the hospital for testing, and there are currently no laws in Namibia to protect such women.
“We, at the hospital, are hoping that these workshops will help the men understand HIV/Aids better,” he said.
No single factor has been identified as the cause of the high prevalence rate in the region, but the government believes that the Trans-Caprivi highway, which links Namibia with its landlocked Southern African neighbours, is one of the main factors that have contributed to the pandemic.
“We have a number of relatively large projects that came with the construction of the highway, and these increased the movement of trucks through the area, inevitably adding to the high rate of infection — as it would in any other area.
“We must also note that the people of Caprivi have direct cross-border access to Botswana, where the HIV prevalence rate, in some parts, has been reported to be over 60%,” Forster explained.
The Southern African Development Community governments, including those of Namibia, Zimbabwe, Zambia and Botswana, are part of a regional initiative that aims to control and curb the transborder spread of HIV. This effort is being supported by similar initiatives from the British Department for International Development and the United States Agency for International Development.
Markus Goraseb, deputy director for social programmes at the Ministry of Health, said Namibia is addressing the pandemic in the Caprivi region as a priority in its third national HIV/Aids plan.
Through its ambitious Third Medium-Term Plan (MTP III), the government hopes to reduce the HIV/Aids prevalence rate of 22% by more than half over the next five years.
“MTP III is a multisectoral response to the pandemic, involving all sectors, including NGOs and the private sector,” Goraseb said.
The plan will run until 2009 and cost more than $575-million. The Global Fund to Fight Aids, Tuberculosis and Malaria has already committed $124-million towards the programme.
The Namibia Business Coalition on Aids, a local initiative conceived in 2002 to raise resources and skills to address the pandemic both at the workplace and in the community, is one of the organisations actively involved in the fight against HIV/Aids.
The coalition’s acting project manager, Peter van Wyk, said it has also increased its focus on the Caprivi due to the high HIV prevalence rate there.
He said companies with businesses in the Caprivi have incorporated HIV/Aids awareness programmes in their work to increase the dissemination of information on HIV/Aids prevention.
A 2002 HIV/Aids survey, conducted by the coalition, found that 72% of the companies operating in the Caprivi were aware of the devastating impact that the disease could have on their businesses. However, the study showed that only 25% of all those companies had programmes in place to fight the disease by creating greater awareness among their employees. — IPS