Like Chief Nanga in Chinua Achebe’s ‘A Man of the People’, today’s politicians in Zimbabwe ‘preach one thing and practice another’, writes Levi Kabwato.

Monica Glenshaw District medical officer for Buhera, Zimbabwe: The Lancet publishes an obituary

Monica Glenshaw District medical officer for Buhera, Zimbabwe. Born on Nov 16, 1941, in Van Dyk, South Africa, she died from breast cancer in Harare, Zimbabwe, on Sept 20, 2010, aged 68 years.

Monica Glenshaw, growing up in the white enclave of a South African gold-mining village, had no idea that 90% of black Africans lived in dire poverty. But exposed as a student to the realities of life in Soweto by a Catholic women’s group that ran sewing classes in the township, her life began to take a different direction. “I knew I had a debt to pay”, she told friends a great deal later.

Recognising the immense need around her, Glenshaw embarked on medical studies and a path that took her eventually, in 1985, to Murambinda Hospital in Buhera, one of the poorest provinces in Zimbabwe, where she became medical superintendent and then district medical officer as well. For 25 years she dedicated herself to saving lives and improving the health care of the people of the region while pioneering programmes for HIV care in Murambinda that were later rolled out across Zimbabwe. Murambinda became a model for rural health care, in defiance of restricted funds and a tense political situation.

“She really was a very impressive person and I am sure the community in Buhera will miss her terribly. She will be impossible to replace”, said Professor David Sanders, director of the public health programme at the University the Western Cape, adding that “DMOs like her are perhaps the most skilled of all medical practitioners and far too little importance is accorded to training and supporting such people.”

Glenshaw set herself to improve the standards of care across Buhera, installing running water in outlying clinics and using World Bank funds offered for upgrading one hospital in each province to improve both Murambinda and Birchenough Bridge as well. At Murambinda, which she ran in close partnership with matron Sister Barbara Armstrong of the Little Company of Mary, she introduced a nurses’ training school, which now makes a substantial contribution to the training of nurses in Zimbabwe.

In the early 1990s, with no treatment for patients with AIDS, both hospitals developed home-based care programmes under Glenshaw’s guidance. In 2001, she introduced a pioneering programme to prevent mother-to-child transmission of HIV, run by a young physician colleague, Anna Miller, and with support from the University of Bordeaux in France and the Elizabeth Glaser Paediatric AIDS Foundation in the USA. “The programme proved that prevention could succeed in a resource poor setting in rural Africa-something which had previously been in doubt in academic health circles”, wrote Miller. Glenshaw also forged partnerships with Médecins Sans Frontières and TB Alert. “There is nothing heroic in treating TB”, said Glenshaw. “But we can cure it, and although 50% of the TB patients we see are HIV-positive you can make a real difference to their lives. Un-combated, TB will accelerate the devastation of the AIDS epidemic. But you can treat it. There’s no substitute for just going on, patiently, doggedly, doing it properly.”

Glenshaw was the third child of a gold assayer and his wife. She had wanted to become a vet, but her school grades were not good enough, so she did a 2-year diploma in agricultural studies. Her brother Peter told her she could do something better with her life and introduced her to a Catholic women’s organisation called The Grail in Johannesburg, which opened her eyes to the sufferings of the black majority in her country. She took a BSc in chemistry and botany and then enrolled in the University of Witwatersrand to study medicine, where she was about 10 years older than the rest of her class. Glenshaw was clear about her destiny, choosing to do her electives not in prestigious white hospitals but in Baragwanath in Soweto, and at both Hlabisa and Nqutu in KwaZulu Natal. After a first job in Nqutu, she went to work in Zambia for some years, appalled by South African apartheid. She returned to South Africa in 1979 but left 2 years later for a job with Oxfam in Mutare, Zimbabwe.

By 1985, when she applied for the job at Murambinda, she was ready to settle for good. “A whole section of your brain rests”, she said. “All the questions of ‘What am I going to do next?’ are quietened and you can think of other things.” Glenshaw was a dedicated doctor, but her friends also talk of her zest for life-her love of the arts and literature and gardening but also of a party, a drink, and her Jack Russell pup, Nutu, from whom she was inseparable.

Sarah Boseley

And in Harare, the late Dr Glenshaw is given the Lynde Francis Award:

The United States Government, through the U.S. Agency for International Development (USAID), will host the 10th annual Auxillia Chimusoro Awards Ceremony in Zimbabwe.  The Auxillia Chimusoro awards honor individuals or organizations that have excelled in their involvement in the fight against HIV and AIDS in Zimbabwe.  The awards are given to individuals who have demonstrated substantial contributions in communication, leadership, social investment and any outstanding works that have made a remarkable impact in Zimbabwean society in mitigating the effects and impact of HIV and AIDS.

The awards are named after Auxillia Chimusoro, one of the first individuals to disclose their HIV positive status in Zimbabwe.  In spite of the significant social stigma attached to HIV and AIDS at that time, Chimusoro publicly disclosed her HIV positive status in 1989 to promote greater awareness and to help change behaviors that increase the risk of infection.     Auxillia founded Batanai HIV/AIDS Support Group in 1992 and was one of the founders of the Zimbabwe National Network of People Living with HIV/AIDS.  She also worked with several support groups before her death in June 1998.

This year, a new award category has been added in honor of Lynde Francis, a tireless HIV/AIDS advocate who recently succumbed to the disease.  The Lynde Francis award is given to a deserving individual or institution whose actions have made a remarkable impact on the course of the epidemic in Zimbabwe.

The first recipient of the Lynde Francis award is the late Dr. Monica Glenshaw, former District Medical Officer for Manicaland and Superintendent of Murambinda Hospital for 30 years. The winner of the Communication Award is Catherine Murombedzi, the first journalist in Zimbabwe to publicly reveal her positive status.  Dr. Owen Mugurungi of the Ministry of Health and Child Welfare won the Leadership award in recognition of his outstanding leadership within the national programme to fight HIV/AIDS.  The winner of the Social Investment Award is Africaid, which runs the Zvandiri HIV Programme for adolescents.

Since 2000, the United States government has invested over $245 million in Zimbabwe’s fight against HIV/AIDS.  U.S. plans for HIV/AIDS assistance to Zimbabwe calls for an increase of $10 million in 2011, bringing the total annual U.S. investment in fighting HIV/AIDS in Zimbabwe to around $57 million.   Part of this plan for increased assistance is to raise U.S. support for anti-retroviral drugs from an amount sufficient for 60,000 Zimbabwean AIDS patients in 2010 to 80,000 next year.

“We share a common vision for Zimbabwe’s tomorrow – a future where there are far fewer people contracting the HIV virus and where everyone in need has access to AIDS treatment. We congratulate all the Auxillia Chimusoro awardees for their outstanding contributions,” said American Ambassador  Charles Ray.

Karen Freeman, Director of USAID in Zimbabwe, added, “USAID is proud to have been a sponsor of the Chimusoro awards over the years.  We know that, in the fight against HIV and AIDS, every individual and organization can make a difference.  USAID is an active partner in this common struggle.”

The Research and Advocacy Unit (RAU) and Zimbabwe Association of Doctors for Human Rights (ZADHR) have released a report entitled “No Hiding Place: Politically Motivated Rape against Women in Zimbabwe.”  This report is accompanied by a DVD “What about us?” Both the report and the DVD focus on the experiences of women members of a voluntary network set up to provide support for female victims of politically motivated rape.

Read the report here

An appeal fromAVAAZ to sign a petition in support of WikiLeaks:

The chilling intimidation campaign against WikiLeaks (when they have broken no laws) is an attack on freedom of the press and democracy. We urgently need a massive public outcry to stop the crackdown — let’s get to 1 million voices and take out full page ads in US newspapers this week!

http://www.avaaz.org/en/wikileaks_petition/?vl

WikiLeaks isn’t acting alone — it’s partnered with the top newspapers in the world (New York Times, The Guardian, Der Spiegel, etc) to carefully review 250,000 US diplomatic cables and remove any information that it is irresponsible to publish. Only 800 cables have been published so far. Past WikiLeaks publications have exposed government-backed torture, the murder of innocent civilians in Iraq and Afghanistan, and corporate corruption.

The US government is currently pursuing all legal avenues to stop WikiLeaks from publishing more cables, but the laws of democracies protect freedom of the press. The US and other governments may not like the laws that protect our freedom of expression, but that’s exactly why it’s so important that we have them, and why only a democratic process can change them.

Reasonable people can disagree on whether WikiLeaks and the leading newspapers it’s partnered with are releasing more information than the public should see. Whether the releases undermine diplomatic confidentiality and whether that’s a good thing. Whether WikiLeaks founder Julian Assange has the personal character of a hero or a villain. But none of this justifies a vicious campaign of intimidation to silence a legal media outlet by governments and corporations. Click below to join the call to stop the crackdown:

http://www.avaaz.org/en/wikileaks_petition/?vl

Ever wonder why the media so rarely gives the full story of what happens behind the scenes? This is why – because when they do, governments can be vicious in their response. And when that happens, it’s up to the public to stand up for our democratic rights to a free press and freedom of expression. Never has there been a more vital time for us to do so.

From PlusNews:

Risky sex does not equal HIV risk – study

JOHANNESBURG — Zimbabwean women reported significantly less risky sexual behaviour than their counterparts in Tanzania, despite being almost four times more likely to be HIV-infected, a comparative study has found.

Researchers from the Universities of Zimbabwe and Oslo in Norway disseminated data from pregnant women who visited antenatal clinics in Moshi, Tanzania, and in Harare, capital of Zimbabwe, between 2002 and 2004. The women answered questions about their sexual behaviour, medical history and socio-demographic background and were tested for HIV and several other sexually transmitted infections (STIs).

HIV prevalence among the Zimbabwean women was nearly 26 percent against about 7 percent among the Tanzanian women. Risk of infection rose with age for women in both countries up until the 25 to 29 age group, after which it started to decline for the Tanzanian women but continued to rise for the Zimbabweans. The Zimbabwean women also had somewhat higher rates of STIs, but this may have been the result of more of the women being HIV-positive and more susceptible to such infections.

In the Journal of the International AIDS Society, the researchers described the “unexpected phenomenon” revealed by the data gathered on the women’s sexual behaviour. On virtually every indicator, the Tanzanian women reported more risky behaviour from having had a casual sexual partner in the last 12 months to early sexual debut to being in a polygamous relationship. They also reported much higher levels of alcohol consumption, another behaviour that has been linked to increased sexual risk-taking.

The authors can only speculate about the explanation for this “paradox”. Perhaps by the time the survey was done, women in Zimbabwe had lowered their sexual risk-taking in response to an epidemic that had already claimed so many lives; or maybe they under-reported their sexual risk-taking because such behaviours by women are considered socially unacceptable in Zimbabwe.

Numerous studies have failed to provide definitive answers as to why HIV prevalence in sub-Saharan Africa varies so widely, with some countries recording infection rates of less than 2 percent and others recording rates of more than 20 percent.

It has long been assumed that different norms relating to sexual risk-taking from one country to another played an important role, but the recent findings suggest that other factors may be more important. The result has implications for the design of HIV prevention programmes, especially those aimed at sexual behaviour change.

The male partners of the Tanzanian women were much more likely to be circumcised, but the effect of male circumcision was not apparent in the study findings.

One possible explanation for the severity of Zimbabwe’s HIV problem compared with Tanzania’s, write the authors, is the role that non-sexual transmission of HIV may have played in the early years of Zimbabwe’s epidemic. They cite a 1990s study which found a 2.1 percent HIV prevalence among 933 women with no reported sexual experience.

“Early in the epidemic, syringes weren’t sterilized properly,” said lead author of the study, Munyaradzi Mapingure, from the Department of Community Medicine at the University of Zimbabwe. “We’re not blaming anyone, because people probably weren’t aware of it, but people who grew up in Zimbabwe in the 1970s were put in a queue and vaccinated with one needle.”

The theory that large-scale non-sexual transmission of HIV can explain severe epidemics like Zimbabwe’s is “very controversial”, admitted Mapingure, but “something we have to bring into the discussion”.

“Most HIV prevention programmes are failing because they focus on sexual behaviour,” he told IRIN/PlusNews over the telephone from Harare. “We need to look at the whole sexualization of HIV.”