- Zambia in a quagmire over Aids testing
Zarina Geloo | Lusaka, Zambia
16 September 2004 11:00
Voluntary testing or mandatory testing? That is the question Aids
activists and government officials are grappling with in Zambia, where
about one million people have already died in the pandemic since the
The United Nations Joint Programme on HIV/Aids puts adult HIV
prevalence in Zambia at about 19%. The country has a population of about
As a draft national Aids policy is still under discussion, lawmakers
have yet to finalise their position on the matter of testing.
However, the National Aids Council, which coordinates the activities of
all organisations working to combat HIV, has announced plans to place at
least 100 000 people on anti-retroviral (ARV) therapy by 2005 -- and
called for mandatory Aids testing in hospitals and clinics to form part
of the programme.
This provoked a storm of protest from activists and people living with
HIV and Aids, who claim that compulsory testing is an abuse of human
rights -- flying "in the face of civil liberties".
Kunima Banda from the Network of People Living with HIV and Aids says
mandatory testing would cause people to avoid going to hospitals when in
need of treatment.
"The way to go would be to scale up VCT [voluntary counselling and
testing] so that it is always voluntary, and people will be properly
prepared for their results," she says.
A former health minister, Nkandu Luo, has added her voice to the chorus
She notes that more work needs to be done to ensure Zambia's health
facilities are fully capable of dealing with the Aids pandemic -- and
that introducing mandatory testing before this has been achieved would
Luo, who has just conducted nationwide research on the availability of
VCT sites in the country, says testing and counselling services at many
clinics are not up to scratch. In addition, some facilities have
insufficient ARVs and suffer from inadequate training of medical
personnel in dispensing drugs.
While people in outlying areas may want to be tested for HIV, the
facilities that could enable them to do so are often located too far
from their communities. Those who succeed in visiting a clinic may find
that testing kits have run out -- and that information on how to access
ARVs is sketchy.
In fact, Luo says, the general lack of information about the pandemic
means that many people still think of HIV and Aids in terms of
witchcraft: "In this scenario, how can government want HIV screening
to be mandatory? [We need to put] first things first: information and
prioritisation of resources, so that systems and facilities are in place
[with] support for people on ARVs, [such as] good diet and
Maybin Kumwenda, who tested HIV-positive in 2000, says part of him
still wishes that he did not know his status, as this knowledge has
brought him a lot of sympathy -- but little in the way of tangible
Like many Zambians, Kumwenda is poor and cannot afford ARVs, even those
subsidised by the government. Although he should be keeping his health
up by having three square meals a day, this isn't always possible.
"I see many people in my shoes ... I do not think mandatory testing
is the way to go in the absence of a strong social support system,"
But health officials view things differently.
A doctor, Gregory Manda, says the initial burst of enthusiasm created
by the opening of VCT centres has died down -- and that there is now a
slow trickle of people wanting to be voluntarily screened for HIV.
He adds that sensitivities around HIV testing have also created the
bizarre situation where medical staff who suspect that a patient may be
HIV-positive nonetheless test for a variety of other ailments first -- a
process of elimination that is expensive and time-consuming.
"Because of this human rights and liberties fear that surrounds HIV,
we leave HIV testing as a last resort when it should be first, and the
patient should be told and counselled on admission. That way, the
patient is treated quickly and there is a minimum wastage of resources
on unnecessary tests," says Manda.
He notes that a more direct and less embarrassing approach would also
be to the advantage of medical personnel -- whose behaviour is affected
by attitudes towards HIV and Aids.
"Can you imagine if a patient who has been in the hospital for some
time suddenly finds medics treating him with extreme caution because
they have just discovered his HIV status? ... It is happening now in our
institutions; people do not need to be told their status -- it shows in
the different way they are treated once tested."
Nurse Suzgyo Mukande also believes that, while voluntary testing would
be the best option, the government needs to take an unpopular position
on this matter for the general good.
"We have a VCT centre in the hospital grounds but few people make use
of it -- only those who are very sick and have been coerced into
testing," she says.
Mukande believes that if every single person who visits a health centre
is informed of his or her HIV status, there will be a reduction in the
cost of diagnosing and treating illnesses.
This will free up funds to provide additional resources for the health
and safety of medical personnel, she adds. At present, items such as
disposable gloves, needles and protective sheeting and disinfectants are
always in short supply.
"If HIV testing is mandatory, government would in turn be obliged to
scale up services in health institutions. It would also mean a refocus
on the entire health sector with more resources both in personnel and
funds," says Mukande.
Decision-makers in other spheres have gone ahead with mandatory
testing, even though this flies in the face of the Southern African
Development Community Code of Conduct on HIV/Aids and Employment --
which explicitly forbids compulsory Aids tests in the workplace.
The Konkola Copper Mines conglomerate, for example, has stated that its
miners will be screened for HIV to enable the company to formulate a
comprehensive health policy for employees. Zambia's Ministry of
Defence has also decreed mandatory testing for new recruits.
Current Minister of Health and retired soldier Brian Chituwo has since
been put in the awkward position of agreeing that mandatory testing does
clash with civil liberties -- while defending the government's
decision to screen its troops.
Manda says that Chituwo's statements speak volumes about the
confusion on this topic: "There is no consensus in government." --
Zambia suspends oil exports to neighbours
17 September 2004 11:39
Zambia has temporarily suspended exports of crude oil to neighbouring
Zimbabwe and the Democratic Republic of Congo (DRC) after fuel shortages
hit the Southern African country, state media reported on Friday.
The suspension will remain in force until the situation improves in
Zambia, said the report in the state-run Zambia Daily Mail, quoting
Energy Minister George Mpombo.
The fuel shortages in Zambia have been caused by a defect in the
machinery at the country's sole oil refinery plant, which is currently
being repaired, Mpombo told the newspaper.
He said the current stock in the country could not meet the export
demands to Zimbabwe and the DRC, the newspaper said.
Zambia has been experiencing fuel shortages, especially diesel, in the
past few days due to technical problems at the Indeni Oil Refinery
plant. -- Sapa-AFP
Zimbabwe forcibly evicts black farmers
17 September 2004 13:41
advertisementHundreds of black peasant farmers in Zimbabwe were this
week forcibly evicted from two formerly white-owned farms that they
occupied during the 2000 land invasions, witnesses, civic groups and
police said on Friday.
A witness said he saw scores of huts on fire after riot police had
ordered all farmers without official permits to settle on the properties
Police confirmed they were involved in the exercise to remove the
farmers "who had imposed themselves" on the farms situated about 50km
north of the capital, Harare.
"Yes, we moved in to remove them ... [and] some of the houses were
burnt in the process," police spokesperson Wayne Bvudzijena said in an
He said the farms are for ranching and not suitable for crop growing,
yet all of the farmers who had settled on them had planted maize and
other food crops.
"Hundreds of new farmers and their families are stranded at Little
England and Inkomo farms ... after police torched and destroyed their
huts following a government order to evict them," said a coalition of
human and civic-rights organisations, Crisis in Zimbabwe.
Police said a series of meetings had earlier been held between
government officials and the settlers on the plan to evict them.
A witness said the farms are to be re-allocated to large-scale
commercial black farmers, while the evictees have not been given
The government embarked in 2000 on land reforms that saw veterans of
the liberation war along with pro-government supporters invading
The farms were parcelled into smaller pieces of land and allocated to
landless blacks, some of whom had left their crowded communal rural
homes to move to the new settlements.
Under the land-reform programme launched in 2000, nearly 4 000 of the
country's 4 500 white farmers, who owned 70% of Zimbabwe's most fertile
land, lost their property.
The controversial land reform plan is cited as one of the reasons for
the economic crisis in Zimbabwe, once Southern Africa's bread basket. --
Tanzania's house of tyres
By Daniel Dickinson
BBC, Dar es Salaam
An intoxicating cocktail of smells hits you as you enter Charles
Lugenga's house; rubber, tarmac, oil all combine to make a whiff that
you probably would not want to experience in your own house.
But then again Charles Lugenga's house is no ordinary house.
It is made, apart from a few supporting wooden struts, exclusively out
of worn-out tyres picked up off the streets of Dar es Salaam.
Set among more typical breeze-block residences in a city suburb, it is
a bizarre sight.
Its roof is an uneven jumble of unravelled tubes.
Inside, with expansive and enthusiastic gestures the proud owner shows
me a single large room with a carpet woven from tyre-strips as well as a
table and two comfy chairs made from tyres which once graced cars, buses
and agricultural machinery.
A sign on the roof declares it as the "First tyre house in the world".
Well, it is certainly the first of its kind in Tanzania and what is
more it has a serious message.
"I want people to think first about recycling and then how they can
make money from solid industrial waste like tyres," says Charles
Lugenga, of the Environment Based Poverty Alleviation foundation. (EPBA)
Solid industrial waste is rapidly becoming a serious problem in
Tanzania and tyres are perhaps the most visible example of this.
When you start looking, you see tyres and remnants of tyres discarded
everywhere, blighting the landscape; by city roads, in rural fields, on
beaches, well just about everywhere.
It used to be different, according to Charles Lugenga.
"In Tanzania, there was traditionally a culture of recycling. Worn-out
tyres were snapped up and all sorts of household objects were made from
them; shoes were always popular."
But that all changed as a result of trade liberalisation, says Mr
"Trade liberalisation boosted our economy. Gradually there were more
vehicles on the road and more and more discarded tyres. These are the
tyres which now scar our country."
And it's not just the landscape the tyres are ruining. Left by the
roadside, they can often cause accidents on Tanzania's busy highways.
They are also perfect breeding places for mosquitoes if water collects
in the rims.
No-one will ever live in this house, even though once it is painted,
the acrid smell will disappear, Mr Lugenga assures me. It is meant more
as a symbolic statement that something needs to be done about the
problem of solid industrial waste.
"This house shows that with imagination, tyres can be recycled
EPBA is now holding workshops aimed at persuading people to make new
objects out of tyres; lamp shades, tables, chairs and the once
ubiquitous rubber sandals.
It is not clear exactly how far scavenging for used tyres in the quest
for creativity and environmental friendliness will help to clean up
Tanzania's blighted landscape but it can only be a good thing.
And as I drive away from Charles Lugenga's unique house I can't help
but admire that his sandy drive is lined on both sides with what else:
- 'Voting doesn't fill the belly'
12 December 2004 23:59
Mozambique's ruling party, Frelimo, surged ahead last week in unofficial results from the country's recent election, puzzling analysts who had expected a neck-and-neck finish with the opposition Renamo. At the same time, evidence of ballot-stuffing in some remote districts cast a shadow over the clean bill of health that international observers gave the elections.
Projections suggest that Frelimo's presidential candidate, Armando Guebuza, will get 60% of the vote, as compared with 35% for Renamo's Afonso Dhlakama, who in 1999 collected nearly 48% of the vote. These projections are based on results posted by individual polling stations and collected by Radio Mozambique correspondents around the country.
The sharp drop in Renamo support was accompanied by an equally dramatic fall in voter turnout, with numbers expected to be between three million and 3,5-million: less than half of the eligible voters. Turnout in the 1994 and 1999 general elections was 5,4-million and 4,9-million respectively.
Analysts agreed that abstention had been highest among Renamo's traditional supporters in the largely agricultural centre and north of the country, who felt that the government had let them down, and the opposition had failed to provide a viable alternative.
"People chose to stay in the fields -- voting doesn't fill the belly," said independent journalist Marcelo Mosse.
"In the cities, the absence might have been a criticism not only of [outgoing president Joaquim] Chissano, but also of Guebuza -- he is not someone who inspires support."
The political weekly Savana described the low turnout as "a red card to the political class", which it accused of being out of touch with voters' interests.
Reports of irregularities were concentrated in Tete province in western Mozambique.
"In Tete there was clearly fraud, though not enough to affect the final result," said Luís de Brito of the Electoral Institute of Southern Africa (Eisa).
He said two voting stations in the province's Changara district had reported turnout of close to 100%, with most of these votes going to Frelimo. De Brito said the high turnout for the province as a whole gave reason for suspicion.
"In Tete, we have an average of 400 voters turning out at each voting table, compared with fewer than 300 per table in all the other provinces."
De Brito said Renamo activists had been forced to leave certain areas of Tete province early in the election campaign, which had prevented them from sending monitors to polling in those areas. Elsewhere in the country, the presence of party representatives during voting and counting was hailed as Mozambique's best safeguards against fraud.
The Mozambican Political Process Bulletin -- an independent newsletter with a wide network of correspondents -- also cited evidence of ballot-stuffing in Tsangano district of Tete province, as well as in Chicono in northern Niassa province. In the latter, 996 out of 1 000 voters registered at one station appeared to have voted, with Guebuza gaining more than 900 of the votes.
Such reports contradicted the positive assessment of international observation teams, who praised Mozambique's strong legal framework for elections, the professionalism of polling station staff, and balanced coverage both in state and private media. Asked why the international teams had not picked up the incidents of fraud cited by Eisa, De Brito said these incidents had occurred mostly at remote and inaccessible polling stations.
The international teams, including Southern African Development Community parliamentarians and representatives of the Commonwealth, the Carter Center and the European Union, were however concerned at the low electoral turnout. Several of the observer teams also mentioned the mistrust that had been created by the party-political structure of the National Electoral Commission, where Frelimo is able to force through decisions by majority vote.
Elderly pay the price for raising Aids orphans
14 December 2004 08:21
Until a week ago, elderly Hannah Dube and her five grandchildren living in the dusty village of Kezi in soutwestern Zimbabwe had been surviving on small portions of dried white melon.
Then Zimbabwe's social services stepped in, handing the 75-year-old Dube emergency aid of the staple corn grain to feed her family, caught in the grip of an HIV/Aids pandemic and a crippling drought.
Her face worn by grief and stress, the aging grandmother's plight in this remote and rural corner of Zimbabwe tells the story of the burden of many other pensioners in this southern African country where HIV/Aids has turned a million children into orphans.
The UN children's organisation Unicef estimates that more than one in five children will be orphaned in Zimbabwe by 2010, with more than 80% of those orphaned by HIV/Aids, which kills about 3 000 people per week on average.
Nine of her grandchildren are orphaned -- she is looking after five children between the ages of five and 13.
Three successive years of drought in this naturally dry region some 600km southwest of the capital, characterised by unproductive soils, and a political and economic crisis have exacerbated food shortages.
"We only eat one meal a day," said Dube, who lives in a hut next to a dusty road, where her cooking fire has long since gone out.
"We are used to it now and there is nothing unusual about it," she said.
While food is available in the shops, people like Dube and her family, who have no source of income whatsoever, cannot even dream of buying any.
Driving up to Dube's home along a narrow dust road, hundreds of people, dangling empty sacks, were seen walking back home, looking tired, hungry and dejected.
They are coming from the local business centre where they had gone to register their names for food aid to be handed out three days later.
"We were told [by an international aid organisation] to come and register our names for food coming next week. But now they say only those on the old list will be given food," Dube said.
The Zimbabwean government this year turned away foreign food aid, saying the country produced enough to feed its people.
But Harare has recently allowed the United Nations World Food Programme to undertake a one-off free food distribution to get rid of its stock left over from April when the government stopped general food aid.
Volunteer workers confirm the hunger in the area.
"It is depressing to go out there visiting the sick, handing out a few bars of soap, diapers, some antiseptic solutions -- but seeing that what is urgently needed is food," said volunteer Georgina Tshabalala.
Dube is not only struggling to provide food for her orphaned grandchildren, but also shelter.
She cleans up grass that fell while she was thatching the roof of her new mud and pole hut in this remote rural area of Zimbabwe.
With nobody to help her build or maintain their home, Dube has to risk climbing onto the roof to patch it up before the rains bring it down.
Inside, the fire has gone out.
Dube said besides the fact that their one meal has already been cooked, she could not afford to keep the fire going because she does not have the energy to regularly go to the bush to cut down firewood.
The elderly woman -- old and weak enough to be a dependent herself -- said she had no choice but to look after her some of her grandchildren.
Those who are not under her wing are probably involved in illegal gold mining, rife in the area.
"I don't really know how they are surviving, but no one helps me with anything. The chickens and the goats you see outside I sell to send these children to school," she said.
Despite the difficult living conditions and lack of food, one of her grandchildren, Dan, (7), passed his year-end school examinations with A grades. - Sapa-AFP
Improved Zim inflation still world's highest
14 December 2004 15:15
Zimbabwe's official inflation rate dropped to 149,3% last month, down from 209% in October, the state Central Statistical Office said on Tuesday. The new rate still leaves Zimbabwe with the highest inflation in the world.
The troubled Southern African country is in the midst of its worst economic crisis since independence from Britain in 1980, with inflation peaking at more than 600% last year.
With the local currency plummeting, sending a Christmas card to Europe by air mail now costs Z$40 000 (about R41) -- twice as much as a one-bedroom apartment did shortly after independence.
A dollar was equivalent to Z$2 at the time, compared with the current official rate of Z$5 600, or Z$8 000 on the black market.
The Reserve Bank attributes the recent drop to tighter fiscal policies aimed at reining in rampant profiteering and a lucrative black market in scarce commodities and hard currency.
However, the official inflation rate excludes prices on a wide range of services and imports that have continued to soar throughout the year.
The cost of medicines, vehicle repairs and health, agriculture and mining equipment has risen by more than 600%. The state telephone and postal companies have increased their fees by 1 000%.
The agriculture-based economy has collapsed in the four years since the government began seizing thousands of white-owned commercial farms for redistribution to black Zimbabweans.
The country routinely faces acute shortages of food, gasoline, hard currency and other imports. -- Sapa-AP