Just a very quick update: I'm back in Finland. The return didn't work out quite the way I was hoping for because I brought a nasty flu with me. I can't meet my friends since I don't want to spread the flu and eating all my favorite foods is useless as well because I've lost my taste. So far, the only joy has been doing my laundry with a washing machine. Besides that, I spend my time mostly by sleeping.
This isn't yet the end of this blog. I have some posts that I've been writing for a “while” now and I'll try to finish them as soon as I get better.
Monday 23 August 2010
Tuesday 10 August 2010
HIV/AIDS
I was talking with a friend about the best ways to avoid advances from Zambian men (“My husband doesn't want me to give my phone number to other men”). She told that one of the things she used to say was “I'm positive.”. It worked otherwise fine but some men answered “It's ok, so am I.”.
HIV and AIDS are present in Zambia in a way that is unimaginable in Europe, even though being openly HIV positive is still rare. My first encounter with it was when another friend was explaining how her friend's husband was sick and how his CD4 count was very low. CD4 count didn't ring any bells with me, so she had to explain what it actually means.
After this discussion, I realized how little I knew about HIV. It could all be summarized with the sentence: “Use condom!”. I had never wondered why HIV has spread so widely in many African countries but I also quickly realized that it's not just about information. Everybody here knows about HIV because everybody has lost friends and relatives because of AIDS.
According to my favorite source, 2007 Zambia Demographic and Health Survey, 14 % of adults aged between 15-49 are HIV positive. In urban areas the HIV prevalence is 20 % compared to 10 % in rural areas. The highest peak in the data is urban women aged 30-34. Over 40 % of them are HIV positive. (These numbers are not very reliable though, as 20 % of those interviewed refused to give blood samples.)
The same source shows also data on HIV/AIDS knowledge. You can look into it in many ways and decide how you want to portray the situation. A pessimist would say that only 35,9% of Zambians have comprehensive knowledge on HIV/AIDS. Optimist would point out that over 80 % know that also a healthy looking person can have HIV and that almost 90 % know that having sex with only one HIV-negative partner reduces risk of contracting HIV. Among the wealthiest and the most educated ones, the level of knowledge is even higher but HIV-prevalence is also highest among them. Obviously, there is a lot of room to improve the knowledge level but no amount of information will solve the whole problem.
Instead, the biggest problem is in behavior. It's very common for men to have several girlfriends, even if they are married. I could tell you amusing stories of married or engaged men trying to hit on me except that they are not really amusing because that is exactly how HIV spreads here. This behavioral difference makes it more likely for HIV to spread here than in the north. Another factor related to this is that HIV is particularly infectious when the infection is new and cannot even be detected in the test. So when the husband gets it from one of his girlfriends in unproected sex, he will soon also transmit it to his wife (and other girlfriends as well.) This is also how HIV is linked to wealth. The poorest cannot afford to have many girlfriends, since the guy is supposed to pay girl's expenses.
(If you think the reason is only condom usage, just have a look at the data on chlamydia in Finland. Chlamydia spreads a lot easier than HIV and is really widespread in Finland. It is actually quite unlikely to contract HIV during one sexual intercourse, though according to statistics, the probability is higher in low-income countries, such as Zambia.)
Another problem is that people prefer not to know about their status. Very few have actually been tested. Women are more likely to be tested ever since many pregnant women get tested, so that the risk of HIV transmission to the baby can be reduced. The ARV treatment is already quite widespread and the coverage is increasing all the time. This brings also hope for more people getting tested when there is actually something that can be done.
What's there to be done? A glimpse of hope comes from that half of Zambians are under 18 and only few of them are HIV positive. Then again, the pressure for them is high. Who doesn't do stupid things as a teenager? For the adults, the requirements are even higher. How does a wife force her husband to use a condom every time? Getting tested sounds simple but how many of us has ever been tested for HIV? And how many would do it yearly?
Based on your choice of statistics, you can decide whether you are pessimistic or optimistic about the HIV situation in Zambia.
(These pics are from the UN Epidemiological Fact Sheet on HIV and AIDS)
HIV and AIDS are present in Zambia in a way that is unimaginable in Europe, even though being openly HIV positive is still rare. My first encounter with it was when another friend was explaining how her friend's husband was sick and how his CD4 count was very low. CD4 count didn't ring any bells with me, so she had to explain what it actually means.
After this discussion, I realized how little I knew about HIV. It could all be summarized with the sentence: “Use condom!”. I had never wondered why HIV has spread so widely in many African countries but I also quickly realized that it's not just about information. Everybody here knows about HIV because everybody has lost friends and relatives because of AIDS.
According to my favorite source, 2007 Zambia Demographic and Health Survey, 14 % of adults aged between 15-49 are HIV positive. In urban areas the HIV prevalence is 20 % compared to 10 % in rural areas. The highest peak in the data is urban women aged 30-34. Over 40 % of them are HIV positive. (These numbers are not very reliable though, as 20 % of those interviewed refused to give blood samples.)
The same source shows also data on HIV/AIDS knowledge. You can look into it in many ways and decide how you want to portray the situation. A pessimist would say that only 35,9% of Zambians have comprehensive knowledge on HIV/AIDS. Optimist would point out that over 80 % know that also a healthy looking person can have HIV and that almost 90 % know that having sex with only one HIV-negative partner reduces risk of contracting HIV. Among the wealthiest and the most educated ones, the level of knowledge is even higher but HIV-prevalence is also highest among them. Obviously, there is a lot of room to improve the knowledge level but no amount of information will solve the whole problem.
Instead, the biggest problem is in behavior. It's very common for men to have several girlfriends, even if they are married. I could tell you amusing stories of married or engaged men trying to hit on me except that they are not really amusing because that is exactly how HIV spreads here. This behavioral difference makes it more likely for HIV to spread here than in the north. Another factor related to this is that HIV is particularly infectious when the infection is new and cannot even be detected in the test. So when the husband gets it from one of his girlfriends in unproected sex, he will soon also transmit it to his wife (and other girlfriends as well.) This is also how HIV is linked to wealth. The poorest cannot afford to have many girlfriends, since the guy is supposed to pay girl's expenses.
(If you think the reason is only condom usage, just have a look at the data on chlamydia in Finland. Chlamydia spreads a lot easier than HIV and is really widespread in Finland. It is actually quite unlikely to contract HIV during one sexual intercourse, though according to statistics, the probability is higher in low-income countries, such as Zambia.)
Another problem is that people prefer not to know about their status. Very few have actually been tested. Women are more likely to be tested ever since many pregnant women get tested, so that the risk of HIV transmission to the baby can be reduced. The ARV treatment is already quite widespread and the coverage is increasing all the time. This brings also hope for more people getting tested when there is actually something that can be done.
What's there to be done? A glimpse of hope comes from that half of Zambians are under 18 and only few of them are HIV positive. Then again, the pressure for them is high. Who doesn't do stupid things as a teenager? For the adults, the requirements are even higher. How does a wife force her husband to use a condom every time? Getting tested sounds simple but how many of us has ever been tested for HIV? And how many would do it yearly?
Based on your choice of statistics, you can decide whether you are pessimistic or optimistic about the HIV situation in Zambia.
(These pics are from the UN Epidemiological Fact Sheet on HIV and AIDS)
Friday 6 August 2010
Zambia in numbers
I was in one library in Lusaka some months ago and I happened to see there Zambia Demographic and Health Survey from 2007. Later, to my great surprise, I found the full book from the internet. I was totally fascinated by all this interesting data of Zambia. In case you don't share my enthusiasm and prefer not to read the 500 pages of statistics, I have copied here some interesting bits.
Population pyramid
Number of usual members in the household
Total fertility rate
Total fertility rate by level of education
Median age for women to give birth for the first time: 19
Married men: Number of wives
Electricity
Rooms used for sleeping
Place for cooking
Cooking fuel
Household effects
Means of transport
Ownership of bank/savings account
All that data reminds me how privileged I am even with my sort of lower middle-class life here in Lusaka. I have heard some not-very-positive comments on the Central Statistical Office, so maybe all the results are not 100 % reliable, but close enough for simple illustrations like this.
Besides these, the survey includes loads of other interesting data. For instance, 45 % of children are stunted because of malnourishment. Only 11,7 % of adult women had drank milk the previous day, and 5,1% had had cheese or yoghurt. 32,9 % of women and 14,1 % of men find that the husband is justified in hitting or beating his wife when wife burns the food.
The book also describes actions taken to fight malaria. During 2007, 3,5 million insecticide treated nets were distributed. That explains perhaps also why I was expected to be giving away nets, as I mentioned here. (64 % of households have at least one net.)
Population pyramid
Number of usual members in the household
| Urban | Rural | Total | |
| 1 | 6,8 | 8,2 | 7,7 |
| 2 | 11,1 | 9,7 | 10,2 |
| 3 | 13,6 | 14 | 13,9 |
| 4 | 14,9 | 15,6 | 15,4 |
| 5 | 15,3 | 16,2 | 15,9 |
| 6 | 12 | 13,7 | 13,1 |
| 7 | 9,2 | 9,1 | 9,1 |
| 8 | 6,4 | 6 | 6,2 |
| 9+ | 10,7 | 7,4 | 8,5 |
Total fertility rate
| Urban | Rural | Total |
| 4,3 | 7,5 | 6,2 |
Total fertility rate by level of education
Median age for women to give birth for the first time: 19
Married men: Number of wives
| Urban | Rural | Total | |
| 1 | 97,1 | 89,6 | 91,9 |
| 2+ | 2,9 | 10,4 | 8,1 |
Electricity
| Urban | Rural | Total | |
| Yes | 52,1 | 3,3 | 20,7 |
| No | 47,9 | 96,7 | 79,3 |
Rooms used for sleeping
| Urban | Rural | Total | |
| One | 22,3 | 45,3 | 37,1 |
| Two | 38,7 | 37,3 | 37,8 |
| Three or more | 38 | 16,6 | 24,2 |
Place for cooking
| Urban | Rural | Total | |
| In the house | 64,4 | 6,9 | 27,4 |
| Has separate kitchen | 45,4 | 5,4 | 19,6 |
| No separate kitchen | 17,3 | 1,4 | 7 |
| In a separate building | 5,7 | 48 | 32,9 |
| Outdoors | 29,6 | 44 | 38,9 |
Cooking fuel
| Urban | Rural | Total | |
| Electricity | 41,2 | 1,8 | 15,8 |
| Charcoal | 50,7 | 10 | 24,5 |
| Wood | 7,5 | 88,1 | 59,4 |
Household effects
| Urban | Rural | Total | |
| Radio | 75 | 54,7 | 61,9 |
| Television | 63,9 | 8,8 | 28,4 |
| Mobile telephone | 67,9 | 12 | 31,9 |
| Refrigerator | 38,6 | 1,9 | 15 |
| Bed | 92,3 | 57,1 | 69,6 |
| VCR/DVD | 34,4 | 2,1 | 13,6 |
Means of transport
| Urban | Rural | Total | |
| Bicycle | 31,5 | 54,1 | 46 |
| Car/truck | 7,9 | 0,8 | 3,3 |
| Animal drawn cart | 0,8 | 7 | 4,8 |
Ownership of bank/savings account
| Urban | Rural | Total |
| 35,6 | 4,9 | 15,8 |
All that data reminds me how privileged I am even with my sort of lower middle-class life here in Lusaka. I have heard some not-very-positive comments on the Central Statistical Office, so maybe all the results are not 100 % reliable, but close enough for simple illustrations like this.
Besides these, the survey includes loads of other interesting data. For instance, 45 % of children are stunted because of malnourishment. Only 11,7 % of adult women had drank milk the previous day, and 5,1% had had cheese or yoghurt. 32,9 % of women and 14,1 % of men find that the husband is justified in hitting or beating his wife when wife burns the food.
The book also describes actions taken to fight malaria. During 2007, 3,5 million insecticide treated nets were distributed. That explains perhaps also why I was expected to be giving away nets, as I mentioned here. (64 % of households have at least one net.)
Tuesday 3 August 2010
Crossing borders
During Easter holiday, I went to Malawi. The border crossing there was a bit confusing but painless. I took a direct bus from Lusaka to Lilongwe and the bus didn't need to stop at the border for a very long time. In fact, there was very little queuing, which surprised me.
On the way back, I took a minibus to Mchinji and a share taxi from there to the border. After crossing the border, I was in another share taxi waiting for it to fill up. There was a Zambian man there who had also been in the previous share taxi. I asked from him whether he knew where the two women from that taxi were. He smiled and said: “Oh they, they took the other way.”. I stared at him with my eyes wide open. After that, he explained that they didn't have passports, so they crossed the border somewhere in the bushes.
Later, I learned how difficult and expensive it is to get a passport. Even if you get a passport that is valid for five years, the government might change the passports forcing you to get a new before the old one has expired. And naturally, you need to pay again for the passport.
I was talking about that with a friend and she explained how she hasn't had a valid passport for some years now. That woke up my curiosity because I knew she had been to Tanzania recently. She had also taken the “other way”, and she told that it is really common. After that, I even read a story about it in a newspaper (which I can't find from the internet now).
Some weeks ago, I went to Zimbabwe for a long weekend. I took again a direct bus from Lusaka to Harare. This time, the border controls were tight. Zambian exit controls were together in the same, modern building with the Zimbabwean exit controls. The queues were long and it took almost two hours before the bus could continue. Everyone's passport was checked before re-entering the bus. This time, no-one could take the other route. I don't know is it because the river makes it easier to control the border, or does the other way exist somewhere else. At least, it isn't that simple in the Zimbabwean border.
The long queues in the Zimbabwean border made me realize how big part of the bus passengers must have crossed to Malawi illegally. Nobody seems to think it as a big deal, so the officials have a lot to do if they are planning to stop it.
On the way back, I took a minibus to Mchinji and a share taxi from there to the border. After crossing the border, I was in another share taxi waiting for it to fill up. There was a Zambian man there who had also been in the previous share taxi. I asked from him whether he knew where the two women from that taxi were. He smiled and said: “Oh they, they took the other way.”. I stared at him with my eyes wide open. After that, he explained that they didn't have passports, so they crossed the border somewhere in the bushes.
Later, I learned how difficult and expensive it is to get a passport. Even if you get a passport that is valid for five years, the government might change the passports forcing you to get a new before the old one has expired. And naturally, you need to pay again for the passport.
I was talking about that with a friend and she explained how she hasn't had a valid passport for some years now. That woke up my curiosity because I knew she had been to Tanzania recently. She had also taken the “other way”, and she told that it is really common. After that, I even read a story about it in a newspaper (which I can't find from the internet now).
Some weeks ago, I went to Zimbabwe for a long weekend. I took again a direct bus from Lusaka to Harare. This time, the border controls were tight. Zambian exit controls were together in the same, modern building with the Zimbabwean exit controls. The queues were long and it took almost two hours before the bus could continue. Everyone's passport was checked before re-entering the bus. This time, no-one could take the other route. I don't know is it because the river makes it easier to control the border, or does the other way exist somewhere else. At least, it isn't that simple in the Zimbabwean border.
The long queues in the Zimbabwean border made me realize how big part of the bus passengers must have crossed to Malawi illegally. Nobody seems to think it as a big deal, so the officials have a lot to do if they are planning to stop it.
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