Saturday, July 08, 2006

HIV/AIDS in rural Zambia

The Zambian health deputy minister Chilufya Kazenene has raised alarm about HIV/AIDS in rural areas reaching alarming levels in the next few years if the current interventions are not scaled up as a matter of urgency.

It will be very sad if some rural areas in Zambia which currently have relatively low prevalence rates of HIV/AIDS start to experience an upward swing in the spread of this virus because very little is being done to ensure that things do not get worse in the rural areas. Zambia has areas like Northern Province with 8.3 per cent infection rate and North-Western Province with 9.2 per cent but very little is being done to help these provinces push down these rates. Obviously areas like Lusaka with 22 per cent infection rates and Copperbelt with 19.9 per cent will definitely require more resources to deal not only with prevention, but also treatment, but this should not mean that the areas with low infection rates should receive negligible attention because soon they will also catch up and it will be a question of closing the stables after the horses have bolted. More work and investment in rural areas can help keep the rates of infection under control.

It is so important that public health officials in Zambia realise that prevention of HIV is of paramount importance. The trouble is that when HIV/AIDS is concerned the culture is often one of 'fire fighting' rather than one of prevention. There is a lot that can be done to reduce or keep under control the prevalence rates in rural areas but not enough is being done. Zambia is spending a disproportionate amount of resources in dealing with the HIV/AIDS problem in urban areas than in rural provinces.

Most rural areas don’t even have testing centres. It is very difficult for our rural dwellers to access ARVs. And for those who have some access to ARVs, they have no proper assistance in how to administer this treatment. They also do not have access to periodic or regular CD-4 counts. Those who have some access to ARVs are not properly helped with administration of these drugs. Some of them are swallowing them like beans, endangering their health. These are very strong drugs that need proper management by competent people; they cannot be taken like aspirin or panadol. The money that various donor organisations have been pouring into the fight against HIV/AIDS does not seem to be reaching the intended people.

Zambia has a myriad of non-governmental organisations that have been created to deal with the HIV problem - a good thing in itself. But most of these organisations (NGOs) really do not benefit the people they are intended to serve. Instead, the greatest beneficiaries are those who run them. Money is spent much more on HIV/AIDS workshops and seminars while even the wisdom that comes from such meetings never reaches the intended beneficiaries, especially those in rural areas.

It is very difficult for rural dwellers living with HIV to fight even the most controllable of opportunistic diseases. Most of the rural clinics or health centres do not have even the minimum facilities to diagnose opportunistic diseases like tuberculosis, let alone the means to treat it. The rural clinics and health centres don’t even have drugs for simple diarrhoea and other health complications that people living with HIV are usually open to. To this is added the problem of hunger. HIV patients, especially those on ARVs, need reasonable access to food. But there are so many people in the rural areas taking HIV drugs on empty stomachs.

We therefore urge those who have made fine use of their resources to help us fight the HIV pandemic in this country to start focusing their attention and money on rural areas. Of course, this shouldn’t be at the exclusion or abandonment of urban areas where the problem has today reached very alarming levels. Doing so will be self-defeating. We are calling on them not to forget the rural areas as they battle with the problem in our urban centres. We should not allow the prevalence levels in our rural areas to ever reach those of the urban centres. If this is allowed to happen, we are likely to see an extinction of the rural populations. Let’s act now on the rural HIV problem - tomorrow may be too late. Let’s scale up our efforts, especially in the rural areas, in fighting this horrible virus.

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