University of Zambia Medical Library

HIV/AIDS in Zambia: June - July 1998

"Over 1M Zambians to have HIV by year 2000." By Kema Kasalaba
The Post: July 28, 1998

Over one million people in Zambia between the age of 20-39 will be infected with HIV/AIDS by the year 2000. According to a report by the Central Board of Health, the number of new AIDS cases developing each year from among those persons living with HIV infection would rise to 106, 000 in 2000 and to 119, 000 in 2010. "An average of 300 people every day for the entire decade will die between 2000 and 2010," says the report.

The death toll also is expected to rise. "By 1995, the cumulative number of AIDS deaths from the beginning of the epidemic was estimated at over 200, 000. Over the ensuing 15 years, 1995-2010, an additional 1.6 million Zambians are expected to die from the disease." The report also indicates that the impact of the epidemic will most be severe among adults in the prime working ages and among children under the age of 5.

"AIDS will drastically increase the number, with deaths in this age group reaching 70, 000 per year by the 2000 and 127, 000 per annum by the 2005, or nearly 350 a day by 2005," says the report.

"SAT Programme Consultation with Partner Organisations And AIDS Round Table: HIV/AIDS to 2005 - Sharing a Strategic Vision." By Patrick M. Salamu
Times of Zambia: July 24, 1998

SAT Programme held the strategic workshop with its partner organisations in Zambia at Pamodzi Hotel from 22 - 23 July 1998. In attendance also were other donors like USAID, SIDA, NORAD, UNICEF, WHO etc. The meeting was officially opened by the Canadian High Commissioner to Zambia. Professor Nkandu Luo gave the key note speech.

The Southern African AIDS Training Programme (SAT Programme) is a Canadian Public Health Association Programme in partnership with the Canadian International Development Agency (CIDA). SAT is funded by CIDA through Canadian Public Health Association, as part of Canada's continuing commitment to the global campaign against AIDS, and in recognition of the compelling need to affected African communities for effective and sustainable responses.

SAT's goal is to assist the community sector in Southern African countries to develop and sustain effective AIDS prevention and mitigation programmes for those most in need; and to promote advocacy and services for reproductive health and rights.

The SAT Programme's strategic vision is to encourage and support thematic networks in 1) Gender and Human Rights; 2) Home Care; and 3) Peer Action. SAT will support thematic networks and also continue to support the partner organisations. Groups of the partner organisations were formed and discussed issues concerning the three areas and CIDA-SAT Programme issues for the thematic networks were:

• Membership
• Criteria for membership
• Co-ordination
• Reporting
• Workplan and budget
• Formal meetings

"Infant Mortality Up."
Times of Zambia: July 24, 1998

ZAMBIA has failed to reduce infant mortality as the rate has increased by more than 12 per cent in one decade, a Lusaka researcher said yesterday. Buleti Nsemukila said at a national conference to revise the population policy that instead of reaching the target to reduce infant mortality from 97 to 65 per 1000 live births by the year 2000, infant deaths had increased to 109.

In a paper on potential research areas within the context of the population policy in Zambia, Nsemukila said the 1989 population policy for Zambia had failed in that area and in HIV/AIDS. He noted that the policy document had not made mention of HIV/AIDS and related diseases yet the scourge had become a very serious concern in Zambia. Mr Nsemukila said an estimated 150,000 people had AIDS in Zambia while up to 800,000 were HIV positive.

The high incidence of Tuberculosis (TB) was fast becoming a concern as it was the most single cause of death in hospital of the age 15 and above. "It is therefore clear that successful implementation of Zambia's population policy will depend crucially on an improved understanding of problems and issues associated with demographic processes especially of fertility and mortality," he said. He said talk of the national population council of Zambia, had been a dream since the 1980s and that the dream kept getting blurred as the nation approached the year 2000. He proposed that socio-cultural and economic research should be promoted, and that the use of research be encouraged in policy formulation.

Mr Nsemukila said Government needed to understand the sexual and reproductive behavioural and explain major patterns and trends exhibited in demographic processes.

"CIDA ties aid to AIDS commitment." By Patrick Mwela
The Post: July 23, 1998

Commitment to AIDS eradication programmes has been introduced as an aid conditionality by the Canadian International Development Agency (CIDA). Canadian High Commissioner to Zambia, Dilys Buckley-Jones, addressing a workshop on HIV/AIDS organised by the Southern African AIDS Training (SAT) at Lusaka's Pamodzi Hotel yesterday, advised the Zambian government to show more commitment to the eradication of AIDS programmes if monetary assistance is to come from CIDA.

"Perhaps CIDA funding should be directed to countries where governments display the greatest commitment to tackling the AIDS epidemic," High Commissioner Buckley-Jones said, adding that CIDA was concerned about the level of commitment by African governments towards AIDS prevention campaigns.

High Commissioner Buckley-Jones , however, said CIDA was committed to assisting the infected and AIDS patients from developing countries. She called on non-governmental orgainsations (NGOs) to be in the fore front in taking slow governments to task. High Commissioner Buckley-Jones said in Zambia, health is CIDA's largest sector intervention, and AIDS is interwoven into a number of initiatives they are supporting. At the Consultative Group meeting for Zambia in Paris, High Commissioner Buckley-Jones said Canada made a long intervention on AIDS.

"We remain, frankly, a little despondent that the issue did not receive much collective attention. We also announced a commitment to integrate HIV/AIDS into all our development interventions in Zambia, " High Commissioner Buckley-Jones said. "In much the same way that we already integrate gender considerations. This commitment we intend to keep and we hope that other donors will follow suit."

Health minister Nkandu Luo, speaking at the same function which attracted people from home based care groups all over the country, said NGOs involved with AIDS activities must stand on their own instead of waiting for government to give them money. Luo said government had decided to restructure the National AIDS Programme by forming the National AIDS Council (NAC) which she said would ensure a more effective approach towards combating HIV/AIDS.

The health minister said NAC was, however, yet to be ratified by cabinet before it starts its operations and will comprise nine members whom she will personally appoint " to avoid having people who are not practical". Zambia is listed among the five worst hit countries by the HIV/AIDS pandemic in Southern Africa - others being Malawi, Mozambique, Tanzania and Zimbabwe.

"TB Regarded as Biggest Killer for Women." By Sandra Mubiana
The Post: July 22, 1998

Tuberculosis is now regarded as the biggest infectious killer of women in the world, said Zambia Tuberculosis and Leprosy Trust (ZATULET) executive director David Mundoka yesterday. Mundoka, in press release, said an international research meeting on tuberculosis and gender which was held in Sweden in May 1998, showed that there were very high levels of infection and deaths among women and girls due to tuberculosis.

"It was revealed that over 900 million are infected with tuberculosis in the world today, and one million will die from the disease while 2.5 million will get sick from tuberculosis this year- mainly between the ages of 15 and 44," he said. Mundoka said 60 per cent of all the cases of tuberculosis are young men and women aged between 15 and 44 as compared with war which account for 4 per cent, HIV 3 per cent and heart diseases 3 per cent.

"Women of reproductive age are more at high risk to fall sick once they become infected with tuberculosis than men of the same age and women of this age group are also at great risk from HIV/AIDS which results in young women with tuberculosis outnumbering young men with the disease," said Mundoka.

ZATULET is a non-government organisation (NGO) recently formed to supplement government efforts in the fight against tuberculosis and leprosy in Zambia.

"Bwafwano Club: Beyond the HIV Status." By Fred Simposya
Times of Zambia: July 17, 1998

Most, if not all of them, have tested positive for HIV/AIDS. They have a choice between despondency and hope for the years they are still alive. They chose hope. Members of the Bwafwano Network club in Mpika's Tazara township seem to have come around the reality of their predicament and are finding ways of being their best brothers's keepers in a rare show of comradeship.

After months of living of hopelessness after each was diagnosed with the AIDS virus, a group of women and a few men have come together to launch a business venture they realise will do more than kill idle time and healthy relationship. Group members have realised this venture is their only way of throwing a rope at a drowning man. Tucked away in the heart of Tazara township, the group has been meeting every week since May 25, 1997 to sew clothes and knit some of the most beautiful woolen baby wear and furniture covers.

To date, membership has reached 17 but attendance varies because of transport problems some members experience to get to the meeting place. Their talent and expertise is of high quality and can easily compete with the commercial products that have flooded our shops. But the story of the Bwafwano Network club is not such a fairy tale. Represented in each of the clubs members are deep wounds that are gradually healed.

Club coordinator Harriet Kapeso Lungu, a senior AIDS counsellors in Mpika, says members used to meet in the open until a member of the community, with a passion for sewing and knitting, opened her house to them. Mrs Dorothy Mwansabamba a divorcee with a responsibility of looking after seven children supports her large family through what she sews and knits.

"I became impressed with the idea of women sewing and knitting for a living and decided to join them. I opened up my house to them after seeing they had no proper meeting place." Mrs Mwansabamba is already thrilled with the results so far. "If I can make a living from sewing and knitting I am sure girls who roam the streets can do the same and break from their habits."

Mrs Lungu displayed a wonderfully patterned woolen shawl she offered for K30, 000. "It takes us five days to complete the baby shawl. The only set back we have is we do not have a market yet for the finished products." Mrs Lungu said typical club meetings do not involve knitting and sewing and alone. Members educate one another on HIV prevention, use of condom, caring for orphans. "Subject such as how to break the news of HIV infections, nutrition talks and how to care for one another are discussed."

There are even plans to invite a layer for legal clinics especially to deal with some of the prejudices AIDS victims suffer at the hands of the community and a doctor to provide health tips for positive living. In our support groups we find that we look for our colleagues better their relatives. There are some who have been tested and have accepted to live positive with the virus. Others are nervous but have symptoms and feelings. We accommodate all these types of people is they come for help," she said.

When one member falls sick, the club sells some dresses or woolen knitting to support them until they fell better. Network for Zambian People living with AIDS (NZP) chairman Clement Mufuzi who visited Bwafwano club could not hide their joy at seeing the club members at work. "In all the provinces of Zambia, I have never seen suck skill, organisation and commitment by members to be masters of their own destiny," said an enthused Mr Mufuzi. "Instead of pointing fingers and sentencing people to death we can do something to help this spirit of self reliance."

Tasintha programme coordinator Mrs Clotilda Phiri said she was equally impressed with the clubs achievements. Pastor Michael Bwembwya, of the Baptist church in Mpika confessed that he did not realise such good things existed in his district he promised to advertise their products and introduce the group to women in his church so they could learn from them.

"None of us chose to be HIV positive," said NZP chairman Mr Mufuzi. "But we cannot afford to just sit idle until it is too late. We must do something to help each other."

Although current statistics at Mpika general hospital indicate that from January to December last year 91 HIV/AIDS patients were recorded, there is a likelihood that actual figures could even be more. Mpika hospital acting Medical Superintendent Dr Gilbert Muhemedi Musangu said 31 AIDS patients died last year while 76 others were being treated under the home based care. Mrs Lungu, as senior AIDS counsellor in the district says there can be even more than 300 cases in the district that have not reported to the health institution. Explaining some of her experiences in her job, Mrs Lungu said most people go through a crisis period when they are confronted with the news of HIV infection. "Most of them are confused, some cry, urinate, have their menstrual periods or slap you. Some just feel like killing themselves or black out," she said.

Her group of experienced counsellors give their clients time to take the blow. Eventually some accept the thought of death and receive home based care. The counsellors arrange for pastors to pray for the patients or take some food and milk to the homes. "Now we are handicapped financially an so cannot give such help. It is sad that we cannot follow up our patients because of transport problems."

Bwafwano Network Club, is having a positive impact because the members have come out in the open that they were HIV positive and waned to lead positive lives after that. A number had been to meetings and workshops organised by the Network of Zambia People living with AIDS (NZP) and had come around to accept their situation.

"Children Worst Hit, says Veep."
Times of Zambia: July 16, 1998

Vice- President Christon Tembo says the Zambian child has been adversely affected by the economic restructuring programme and the effects of the HIV/AIDS pandemic. Lieutenant General Christon Tembo said in Lusaka yesterday that it was against this state of affairs that he was appealing to the service providers for children to rise to the challenge of their plight.

The Vice- President was speaking at the official opening of a national consultation on children in especially difficult circumstances in Zambia held at the Hotel Inter-Continental. "I wish to make an earnest appeal to the service providers for children to work out to explain the plight of the Zambian child and how to ameliorate the situation for the betterment of the child. "I have no doubt that at the end of the day, success is assured. In the same vain, I also wish to appeal to you service providers and stakeholders to use whatever resources you source for the benefit of the Zambian child," Gen Tembo said.

He said the human resource was the greatest natural endowment any nation could boast of and Zambia, like many nations alike, was made up of young population with at least six million people being below the age of 35. He noted that children were among the most vulnerable members of society. Gen Tembo said the plight of the Zambian children was not unique to the country alone but rather very common within the region. "This is why I am delighted to note that among the four international speakers at this consultation, three are from the region. We as SADC region must collaborate and interact in dealing with our common problems such as the devastating effects of the HIV/AIDS pandemic."

Earlier, United Nations International Children's Fund (UNICEF) representative in Zambia Peter McDermont was concerned at the increased number of street kids and orphans in the country whose situation was becoming more difficult. He said Government and UNICEF estimated that there were about 70,000 street kids in major cities and towns through-out the country. These numbers were rising due to a number of factors including AIDS, urbanisation and poverty. Mr McDermont said child abuse was perhaps the broadest and vaguest issue of the consultation and hoped the issues would be tackled by the participants.

Youth, Sport and Child Development Minister William Harrington told the participants that Government was committed to the welfare of the child, hence the hosting of the consultation. He said the national plan of action on the Zambian child would soon be in place and appealed for local and international support on the action. The minister thanked UNICEF for its continued financial and technical support to Government on matters related to children especially the under privileged. The workshop, among others, was aimed at examining available information and research data on street children, orphans and abused children.

"Crisis Looming as TB Drug Shortage Persists." By Mildred Mpundu
Times of Zambia: July 8, 1998

One of the most dreaded diseases in Zambia, tuberclosis (TB), appears set to afflict more victims due to a serious shortage of curative drugs in the country. Experts say, with the scarcity of drugs and their prohibitive cost when found at private outlets, the TB germ is bound to spread uncontrollably. The fact that there are no TB drugs is undeniable but nobody seems ready to explain just why this should be so. It is acknowledged the situation is a serious health problem.

"This situation may result into the eruption of the most dangerous type of TB germ called Multi-Drug Resistant (MDR) TB. No amount of Government or community commitment or money may bring the germ back into control," says Webby Mwape, Executive Director of Community Based Tuberculosis Organisation (formerly known as National TB and Chronically Ill Community Monitoring Organisation.) Mwape said there was a shortage of drugs and this left patients with no other option but to default in taking their daily TB drugs.

Some of the dangers inherent in lack of constant supply of the TB drugs include a higher mortality rate among the TB patients owing to relapses. In addition, the infection rate increases owing to haphazard movements of TB patients who use public transport from one health centre to another in search of the elusive drugs. "What is the essence of putting up clinics if there are no drugs to cure patients," asked concerned community workers at Chelston clinic where the TB organisation meets patients monthly for therapeutic treatment and sharing of experiences and problems.

Mr Mwape does not mince his words about the dangers of having a poor TB preventive programme in the country. He says: "We are at risk. The movement of TB patients from one clinic to another in search of drugs, using common public trasnsport, will expose all of us to the infection because TB is air- borne. TB is on the increase and anyone can get it regardless of age and status in society," he adds.

A survey showed that in some clinics in Lusaka the number of patients who visited the centres with suspected TB was as high as 400 per clinic per month. With the shortage of TB drugs, it was obvious that a crisis was looming. The Community-based TB organisation founded by Mr Mwape and his wife Rachel in 1995 after they were faced with a critical situation of looking after nine TB infected members of the family.

The couple went through an experience of looking after four orphans who lost their parents due to TB which was misconstrued as HIV/AIDS. Later, the four orphaned children were found to be TB infected too. Because the children were living in the same house with the Mwapes, five of their children also contracted TB. It was a tough experience for a young couple. After assessing the difficulties they went through in looking after the large number of patients at their home the Mwapes concluded the problem was not only peculiar to them but the majority of families in Zambia.

It appeared there was lack of information about the disease and as a result of that patients and suspected patients could not go to health centres for diagnosis. It was because of this information gap that the Mwapes founded their NGO. Some of its tasks were to looks for cases of TB and bring these to the attention of authorities which resulted in maximum utilisation of healthy delivery service. It also looks at prevention and control of TB more so on drug compliance which is the key for quick recovery of TB patients.

"As a result of active case finding, a lot of TB patients have been diagonised and are willing to comply to treatment through accurate information disemmination," Mwape said. While the organisation has been emphasising on the consequences of defaulting, it appears that they were indirectly encouraging patients to default by not making drugs available to them. A visit to one of the monthly meetings at Chelstone clinic revealed that therapeutic treatment still went on despite the shortage of drugs. Over 100 new and old patients gathered there.

Sister Joyce Lungu gave a health talk to new patients about the disease, how to tell its symptoms and so forth. Project director, Rachel Mwape talked to patients about the continuation phase - what foods to eat, the dangers of defaulting while on TB treatment, prevention and control at home to prevent the spread of the disease. She also stressed on harmful habits like beer drinking, smoking, spitting carelessly and not covering their mouths when coughing. Mrs Mwape explained to patients that even if they came across certian effects of the drug they should not stop taking treatment but report to the clinic.

Patients who attend these health talks come from as far as Kamanga, Chelstone, Avondale, Kabwata, Lusaka West and neighbouring Chelstone farms. Matilda Susu came for the health talk with her 15 year old daughter who has TB. She said there was tremendous improvement in the health of her daughter since NGO started visiting her at her home. "They tell us how to look after the patient and teach us good eating habits. They also tell us that she must have her own eating utensils to avoid spreading the disease to the rest of the family members in the house," Susu said.

Collins Lungu started treatment in April this year after he had been coughing for two weeks and was diagonised with TB. Initially the sputum tests were negative but the x-ray showed he had TB. Lungu who stays in Palabana said he felt better since he started treatment and coming for health talks. He was seriously sick the first two weeks. The only problem he had was that he could not get Refina and PZ (TB drugs) at the clinic and has had to buy them for K8,400 ( a two weeks course).

"Condoms Demand Doubles on Copperbelt."
Times of Zambia: June 30, 1998

The demand for condoms and injectables has doubled on the copperbelt, according to the Planned Parenthood Association of Zambia (PPAZ). The association's regional annual report shows that out of 66,461 people who received different types of contraceptives distributed by the association on the Copperbelt last year, 17,338 people used condoms while 8,770 use injectables. Statistics showed that the number of people who were on the pill had reduced by 2,635 from 1996 where 37,305 people used the pill.

PPAZ Copperbelt regional manager Ms Clara Mwala pointed out that there was a downward trend in the demand for the pill and loop. The number of people who were on the pill had reduced by 2,635 as last year recorded only 34,670 people as the number of acceptors while those who used the loop dropped by 597 leaving the number of acceptors at 140.

Ms Mwala pointed out that the upward trend in the use of condoms was because it protected male and female against the risk of both STDs and HIV/AIDS and also prevented pregnancy. Ms Mwala added that people had also responded positively to the Norplant, a new method of contraceptive for women. "About 302 women have responded to the Norplant. At least five men last year had the Vasectomy, while the demand for women sterilisation is still static," said Ms Mwala.

"Try Out AIDS Ozone Treatment."
Times of Zambia: June 29, 1998

A few years ago, I recall you published a suggested AIDS cure from a New Zealander preacherman, Barry Smith. I am wondering what has happened to that cure. Why aren't our researchers taking it up?

The New Zealander said AIDS can be cured by ozone treatment. That is, by charging an electricity rod with an extra atom of oxygen, passed into a victim's pint of blood until it is bright red. And when such blood is put back in the body, it kills every AIDS virus it encounters.

Why can't our doctors, radiographers, physics experts and the Health ministry of Professor Nkandu Luo try this ozone treatment instead of having several AIDS deaths. After all, we don't lose anything by trying. In South Africa's Soweto township I am told someone has started using this ozone treatment and it's working.

Richmond Mwanza, Lusaka.

"WHO Urges Heads of State to Join Anti-AIDS Campaign." By Reuben Phiri
The Post: June 17, 1998

The World Health Organisation Africa Regional Office (WHO/AFRO) has called for the intervention of political leadership including heads of state in the anti-AIDS campaign. WHO/AFRO regional director Dr. Ebrahim Samba, in a statement released in Lusaka yesterday, said the organisation "is deeply concerned about the unacceptably high HIV/AIDS mortality and morbidity rates in the region".

"Africa, which has only 10 per cent of the world's population, currently has 70 per cent of the 20.8 million global cases of HIV/AIDS," Dr. Samba said. "Every country on the continent has to a lesser or larger degree reported cases of HIV/AIDS which everyday infects 7,500 Africans out of the global total of 16,000 daily infections."

The statement says by the end of 1997, close to 9 million adults, divided equally between men and women, and 1.5 million children born with HIV infection developed AIDS in the region. "Of this, about 7 million children and adults have died," Samba said. He said the most vulnerable groups have been from Africa's most active and productive people aged between 15-40. Dr. Samba said the results have been a weakening productive base, growing orphan population, further strains on already under-staffed and under-funded health services across the continent, and the adverse consequences of all these on Africans' quality of life.

"Factors accounting for this grim situation include the wide practice of unprotected sex, high fertility, high incidence of sexually transmitted diseases, and poor access to care and information," Dr. Samba said. He said efforts so far made to contain the pandemic have included caring for victims and the launching and promotion of sensitization campaigns on safe sex, including the use of condoms. "In spite of these efforts, the situation is worsening," Dr. Samba said.

According to the statement, WHO/AFRO has decided to respond to the situation by embarking on a new initiative which consists of a three way approach. "This includes the mobilisation of Africa's political leadership, including heads of state in the anti-AIDS campaign and the institution of more effective intervention strategies," Dr. Samba said. Other measures include the strengthening of cooperative and collaborative efforts among partners to make maximum use of available resources with a view to making a greater impact in the containment endeavour.

" I call on all member states of the WHO Africa region to embrace this new initiative which will strengthen the capacity of national health authorities to adopt policies and promote practices that offer a better opportunity for monitoring the HIV/AIDS situation, and for improving our understanding of the dynamics of the AIDS pandemic," Dr. Samba said.

President Frederick Chiluba on arrival from the Organisation of African Unity's (OAU) 34th summit in Burkina Faso last week appealed to scientists to find curative measures for HIV/AIDS instead of producing more condoms. Addressing scores of ruling MMD cadres on arrival at the Lusaka International Airport , President Chiluba disclosed that the OAU summit discussed ways to combat the scourge of HIV/AIDS which he said has ravaged Zambia and Africa as a whole. "This is something we cannot run away from. Those who have AIDS must not look for condoms but a cure," President Chiluba said. " We are appealing to our scientists not to produce more condoms but find curative measures."

"AIDS Patients Need Home Care." By Lorriane Mukumba
The Daily Mail: June 16, 1998

Local Government and Housing Deputy Minister Elizabeth Kalenga, has challenged the community to participate in the care of chronically ill patients. Officiating at a Society for Women and AIDS in Africa (SWAAZ) fundraising luncheon in Kalulushi at the weekend, Ms Kalenga said the HIV/AIDS pandemic was a world concern, hence the need for home-based care programmes since the government could not fight the disease alone.

Ms Kalenga commended SWAAZ, Kalulushi chapter for training over 30 health promoters and for attaching four nurses on A full-time basis to the programme which she said was a positive step in promoting home-based care programmes. "May I appeal to all these men and women who have willingly chosen to devote their precious lives to care for the chronically ill in our community to continue with this kind of spirit," Ms Kalenga said.

And SWAAZ Kalulushi branch president Faustina Kapapula, said her association had embarked on a series of fundraising ventures to enable the home-based care promoters to carry out their work in a more human way. Mrs Kapapula said there were a lot of chronically ill patients in homes lacking food and care, adding that people needed to be more sensitive to the plight of HIV/AIDS patients.

"People should remember their friends who are sick by visiting them and provide physical and spiritual help to them," she said. She appealed to the community to get involved in home-based care programmes and help in the fight against HIV/AIDS.

"High AIDS Death Rate Worries WHO."
Times of Zambia: June 16, 1998

The World Health Organisation (WHO) has expressed deep concern at what it terms as unacceptably high HIV/AIDS mortality and morbidity rates in the African region despite the efforts being made to fight the pandemic. The WHO has also embarked on a new three-pronged initiative as a response to the HIV/AIDS problem.

Regional WHO director for Africa, Ephraim Samba said this in a statement released in Lusaka yesterday. Dr Samba said Africa, with only 10 per cent of the world population, currently had 70 per cent of the 20.8m global cases of the HIV/AIDS.

"Every country on the continent has to a lesser or larger degree reported cases of HIV/AIDS which every day infects 7,500 Africans out of the global total of 16,000 daily infections," he said. Dr Samba said by the end of 1997 about nine million adults divided equally between men and women and 1.5m children born with HIV developed AIDS in Africa. Of these, about seven million children and adults were said to have already died. Dr Samba said the most vulnerable groups had been from Africa's most active and productive people aged between 15 and 40 years.

"The results have been a weakening productive base, a growing orphan population, further strains on already under-staffed and under-funded health services across the continent and the adverse consequences of all these on the quality of life of Africans," he said. Factors accounting for this grim picture included the wide practice of unprotected sex, high fertility, high incidence of sexually transmitted diseases and poor access to care and information.

Efforts so far made to contain the pandemic have included caring for victims and the launching of promotion of sensitisation campaigns on safe sex including the use of condoms. Dr Samba said the three-pronged approaches the WHO was embarking on included the mobilisation of Africa's political leadership, including heads of state in the anti-AIDS campaigns. Other measures are the start of more effective intervention strategies and stronger cooperation among partners in the fight to make maximum use of available resources.

"I call on member states of the WHO Africa region to embrace this new initiative which will strengthen the capacity of national health authorities to adopt policies and promote practices that offer a better opportunity for monitoring the HIV/AIDS situation," Dr Samba said.

"Why Home - Based Care is Good for HIV Victims." By Masautso Chipako
Times of Zambia: June 16, 1998

Many people infected with the HIV/AIDS most often have the misfortune of being neglected and shunned by relatives and friends once their predicament has been brought out in the open. Contrary to African traditions and customs which call for care of the sick by relatives in the home and the community, most prefer to dump their sick in hospitals where it is expected nurses and doctors will provide the requisite care.

Some people fear that if the sick died in the home, their houses would be haunted forever and evil spirits trouble the surviving relations while others neglect their now sick relatives out of sheer spite of the victim and fears of contracting the disease. This trend traumatises the victim, congests the hospitals and brings divisions among family members.

The World Health Organisation(WHO) states: "AIDS virus infected persons should, and must, remain in society, for at least two reasons. The first is that, except unprotected sex, blood transfusions and needle sharing all of which can be prevented-AIDS virus infected persons are simply not dangerous to others. "The second reason is that threatening infected people with exclusion or worse will drive the problem 'underground' wrecking havoc with educational efforts and testing strategies." Further stating that: "Therefore, how societies treat such persons will not only reflect fundamental values, but will probably make the difference between success and failure of AIDS control strategies at the national level."

It is on these lines that the Home Based Care (HBC) strives to provide for AIDS patients in the communities with quality professional care. The HBC is a Family Health Trust (FHT) project based in Lusaka which was founded in 1987. The (HBC) project was initiated in 1987 as a direct response to the increasing numbers of HIV infections among them karposi's sarcoma (a skin cancer) patients and to the increasing numbers of HIV/AIDS patients who could not be afforded institutional care because of the terminal nature of the illness.

The HBC was established in 1987 after an American nurse, Virginia O'Donell carried out a survey which involved 150 patients and families and discovered that there was need for care of such patients once they were discharged from hospital. The survey had been necessitated by the number of terminally ill patients who were taking up large number of beds in the already congested hospital. The advent of the double aged Human Immunodeficiency Virus (HIV) and the Acquired Immune Deficiency Syndrome (AIDS) scourge gave rise to the number of people suffering from a skin cancer called kaposi's sarcoma, a skin condition directly linked to AIDS.

Professor Anne Beiley, a British medical doctor who was an expatriate working in the country, set up a study of this trend which was by then making admissions at the hospital impossible. With the success of the pilot study in which it was discovered that 90 per cent of victims of kaposi's sarcoma were HIV positive, it was decided to establish care for the discharged whose condition had a direct link to the HIV and AIDS.

Project manager, Rosemary Zulu, says the project endeavours to make families and communities, in which are AIDS patients, to understand that these are people who need care and not neglect. In its operations, the HBC emphasises on the empowering of AIDS patients and their families, strengthening of the existing community support systems for providing care and reducing the burden of care placed on women who are the main care givers, widows and survivors of deaths of their children and other members of the extended family system.

"The emphasis in our tradition has always been on the care of the sick by the relatives and communities, but with modernisation we have seen this slowly going away where people would prefer to have their sick in the hospital," she says, adding that "what we do really is to provide physical and psycho-socio care for HIV/AIDS patients in the homes in partnership with the community for improved quality of life."

She says that through the families of the patients, the HBC has been able to teach and campaign against the spread of HIV and AIDS. The HBC apart from providing counselling to the patient and care also provides nutritional food supplements like mealie-meal, cooking oil and Soya flour which has become so popular among patients. "We don't buy this food ourselves, it is supplied to us on arrangement with the World Food Programme (WFP) for distribution," says Zulu.

An AIDS patient, Mungo Kachema (not real name), of Kabwata implores other non-governmental-organisations (NGOs) to emulate the HBC so that many people not able to get the services of the organisation due to limited resources could also be taken care of. He said that even people living with the disease should not feel ashamed to bring themselves to the attention of the HBC. "The work the HBC is doing is very noble, but other NGOs must come up and take the challenge of caring for AIDS patients. However, even the patients themselves should be able to come out and identify with the HBC and not feel embarrassed or ashamed about it," said Kachema.

However, the inception of the HBC was not an easy one as most people did not have trust in the organisation, accussing it of turning away the sick from hospital. "But we have established ourselves firmly now and people understand that actually what we are doing is making them perform their duty," the project manager said.

Ms Zulu who is a qualified nurse said that the project was only able to carter for 600 patients at a time and had to be 'little judges' to decide who gets the food as it was not always enough to go round the patients. The HBC's home care office, which serves as the hub of the HBC operations is situated at the University Teaching Hospital (UTH), where most patients who after testing HIV positive at the hospital or have symptoms of the killer virus manifesting are referred to and the first session of the counselling takes place with the consent of the patient. In its initial stage, the HBC depended on nurses and ancillary personnel who were on part time basis, but it now employs its full time personnel.

It has however been observed that people in the high density areas easily accepted the counsel and help from the HBC while their counterparts in the low density areas sought treatment from outside the country and most often decided to seek their assistance when the situation was already helpless.

"It is usually easier for people in the high density areas to come to us because of their financial status. Most in the low density areas prefer to go outside the country and come back already finished," Ms Zulu said. She says the current health reforms in the country are headed in the right direction as emphasis is laid on home care nursing. "To the extent that we exclude infected persons from society; we endanger society; while to the extent that we maintain infected persons within society, we protect society. This is the message of realism and of tolerance," the WHO states.

"Planned Parenthood Association of Zambia Calls For Peer Education In Fight Against HIV/AIDS." By Liseli Kayumba
The Post: June 9, 1998

The importance of using peer educators cannot be over-emphasised when tackling the HIV/AIDS pandemic, Planned Parenthood Association of Zambia (PPAZ) executive director Godfrey Musonda has emhasised. Musonda, in an interview after attending a workshop on sexual reproductive health and the rights of adolescents in Stockholm, Sweden, recently, pointed out that new methods of intervention were needed to tackle the HIV/AIDS.

"The young of today are tomorrow's adults. Peer educators enable the youth to make informed choices," Musonda said. Realising the role the youths played in society, the PPAZ in collaboration with the Family Life Movement of Zambia last year initiated a youth sexual reproductive health project in Kafue where peer educators were trained in the prevention of HIV/AIDS, early pregnancies and other health issues.

The project is funded by the Swedish International Development Agency (SIDA). Musonda explained that the Stockholm workshop was an eye-opener for those who attended it. It drew participants from 25 countries in sub-Saharan Africa and provided an opportunity for different organisations to exchange ideas on how they were dealing with HIV/AIDS problems among the youths.

"Uganda has successfully reduced infection rates amongst its youths. Sweden, which started such programmes long before, also has low rates of infection. Through the exchange of knowledge gained through their experiences, we can try applying similar programmes here," Musonda said. The workshop also provided an opportunity to improve networking between countries. "Namibian representatives were expected to arrive in the country soon to look at the Kafue project," Musonda said. The importance of involving parents in sexual health programmes was also stressed at the workshop.

In conjunction with the District Health Management Board, the PPAZ recently donated seven bicycles to Kabanana community based distributors in Lusaka. "Respected members of the community can now reach out to distant places in their communities and provide information to their members," said Musonda.

"Positive Living HIV/AIDS Organisation Formed." By Reuben Phiri
The Post: June 2, 1998

Lusaka Province has formed an organisation of people living with HIV/AIDS with the aim of creating a strong force that will be able to meet the needs of its members and effectively participate in efforts against AIDS. Officially opening a workshop for people living with HIV/AIDS, the chairperson for the Network for People Living with HIV/AIDS(NZP) in Zambia, Clement Mufuzi, said the commitment was part and parcel of the war against the virus.

"The aim is to see if we could mobilise individuals and support groups in Lusaka with an organised front to share problems and intervention programmes and solutions," Mufuzi said. He noted that it was difficult in the past to get an overwhelming response when it came to HIV/AIDS workshops. "In the past it was each man for himself. Today we want to get together and combine our efforts and be able to use our comparative advantages to make a much stronger body," Mufuzi said.

Amongst the issues that were discussed at the one-day workshop were matters relating to treatment and resource mobilisation. Representatives for Lusaka Province were also elected. The workshop attracted about 40 people living with HIV/AIDS from over five support groups of Lusaka.

"So Much For AIDS, How About Malaria?." By Dr. Mannase Phiri
Times of Zambia: June 2, 1998

Thank you Dr Ben Chirwa for coming out boldly in defence of condoms on behalf of the Central Board of Health - and YOU, Times of Zambia for carrying a quarter page advert for Durex condoms in the same issue (Times, May 28). Zambia so badly needs more of this kind of brave political commitments to the fight against HIV/AIDS - the kind that dispels anti-condom rhetoric, myths and untruths which are perpetuated by certain powerful circles.

We need to take our national head out of the sand and learn from the example of Uganda where strong political anti-AIDS commitment has led to a decline in the rate of spread of AIDS.

While we are at it, can we please also have some political commitment to MALARIA? It is sending more people to clinics, surgeries and hospitals; keeping more people off work; and unfortunately killing more people than any other disease. Malaria is no longer just a public health problem.

"Central Board of Health Defends Condoms."
Times of Zambia: June 1, 1998

WE would like to express our disappointment as Central Board of Health (CBOH) and on behalf of other stakeholders involved in HIV/AIDS prevention programs, about an article that appeared in your May 16 issue quoting an unsighted World Wide Web showing that "condoms have bigger holes than the AIDS virus."

As of September 1997, CBOH organised an expert group meeting to evaluate existing data and reach conclusions about the status of the epidemic in Zambia. The evaluation indicated that in 1997, the estimated HIV adult prevalence rate for the entire country was 19.9 per cent. It also shows that prevalence rates are about twice as high in urban as in rural areas. The overall rate is exceedingly high and shows that Zambia is undergoing one of the worst HIV/AIDS epidemic in the world.

It means that among those Zambians now over the age of 15, one out of five will probably die at a young age from this disease. It is equally important to remember the other side of the picture. More than 80 per cent of the adult population remains uninfected, and all the women and men in this group can actively take measures to protect themselves and help stop the spread of the virus. It is with this reason that we believe it is important to have a strong response to the epidemic from all sectors of Zambian society, instead of destroying measures and interventions that have been put in place by the Zambian government through the Ministry of Health to control the spread of AIDS.

The statement that condoms have bigger holes than the HIV/AIDS virus is unfounded and very alarming. Condom studies have been carried out in which latex condoms (which are available in Zambia) were examined microscopically for evidence of natural-occurring pores. One study, by the US National Institute of Health, found no condom pores when condoms were magnified 2,000 times. A second study, using a scanning electron microscope to magnify condoms 30,000 times (a magnification at which HIV-size particles can be observed) reported that no pores were evident, even when they were stretched.

DR BEN CHIRWA, Spokesman CBOH, Lusaka.

Last updated July 28, 1998

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