My visit to Johannesburg recently brought back memories of my mother, oddly enough, watching the construction that was taking place – the longsuffering looks on the strained faces of drivers who have long resigned themselves to being daily inconvenienced by the activities taking place to spruce up the city before the world comes charging in.

I was reminded of similar days when the family was expecting some important guest and the whole house would be turned upside down and we would be exiled outside with strict orders to steer clear of mama and her broomstick.
I always resented the disruption such visits brought to our lives – there would be the shifting of bedrooms and suddenly I would find myself sleeping on the floor while the ‘dignitary’ enjoy the luxury of my single bed and the comfort of mama’s best sheets and bed linen.

I somehow got the distinct impression that the average South African is hard pressed not to grumble at the inconvenience that the 2010 is bringing as the powers that be pull all the stops to present a sparkling clean image when America, Europe and the rest of the world descends upon them.

And all the while the media keeps harping on about the great ‘opportunities’ that 2010 presents to South Africans as a way of placating them, no doubt – in much the same way my mother used to gain our cooperation to be on our best behaviour by reminding us that the visitors would mean a delectable menu of dishes would be served.

Of course she would neglect to inform us that we would have to settle for the mouth-watering aromas that would waft towards our rooms to which we were confined – out of sight – while the VIPs were served in the family living room and even now I don’t know which was worse – missing my favourite TV shows or having leftovers when I had been promised a scrumptious meal.
So it is with the majority of South Africans whose cooperation has been bought by cleverly worded campaigns, messages, logos and slogans assuring them that they would all have a piece of the 2010 action.

The sad truth however, is that for many South Africans, the World Cup will not translate to any meaningful change in their lives – it will not bring them running water, it will not substitute candles for the brilliance of florescent light, it will not put food on their tables, or clothe their children’s backs or even turn their shacks into concrete palaces.

Recently after interviewing women at the various markets in Johannesburg with the aim of writing a story on how enthusiastic, excited and hopeful they were about capitalizing on 2010 Tanzanian journalist, Angel Navuri met with tales of woe.

“Food vendors cannot take the food to the stadiums because they have been forbidden to go there. It is certain that beneficiaries will be the big hotels, tour operators, and those who already have money will make more money. And the small traders have been excluded from engaging in any economic activity that would have seen them making any significant gains through the 2010,” reported Navuri.

Is it always the case that in order to be hospitable one must, for a time anyway, place the welfare of strangers ahead of their own family, or country men? What is that thing they say about charity beginning at home?
As a child I struggled to reconcile this tendency of being pushed to the periphery whenever more ‘special’ people deigned to visit us with being loved or appreciated in the family.

I mean I seemed pretty dispensable back then and the whims of those visitors took precedence over my needs making me wonder if mama perhaps loved them more than she did me.

But those were childhood musings, as a woman I have grown to resent the hypocrisy that forces us to always ‘keep up appearances’ going so far as to disown, reject and hurt our own.

So whose 2010 is it anyway?

It’s certainly not the market trader’s because they have been told to steer clear of the stadiums (we wouldn’t want the visitors to see them because they’re too plain and might mar the exquisite stadium facilities) instead space will be created to accommodate the fancy restaurants with gourmet chefs and first class menus.

It won’t be the fruit or airtime vendor because they would make the stadiums look shabby and the visitors cannot be expected to put up with the sight of people walking up and down earning an honest living – they can get airtime at the hotels or their taxi drivers can ferry them to the nearest state of the art shopping mall where they will be spared the ugly sights of Johannesburg’s filth lined dark alleys.

School will be closed for the whole month and people will be expected to put their lives on hold while the powers that be pander to the wishes of the Western visitors whose arrival will be expected to leave Joburg awash with freshly minted pounds, dollars, euros and francs amongst other currencies.

And the so called job opportunities and job creation resulting from the 2010 preparations smack of my mother’s subterfuge exaggerating the benefits that would accrue to us if we put up with a ‘little’ discomfort to make room for our esteemed guests.

Asked about how excited (who wouldn’t be right?) the women traders were about all the money they stood to make from foreign clients in 2010; one of them identified only as ‘Mama Ice’ retorted: “This World Cup will come for only 28 days out of a whole year. We have already been told that we are not wanted at the stadiums by the municipality and we hear this FIFA of theirs has standards and we are not good enough for them so what has 2010 got to do with us?”

And they will not be the only ones finding themselves looking in from the outside while the World Cup passes them by as African journalists may very well find themselves playing second fiddle to foreign sports reporters who will be better equipped, better sponsored and probably given preferential treatment ahead of Africans who are after all ‘family’ and can make room for the ‘guests’ – but that’s a story for another day.

I recently read a Plus News report entitled:  Male circumcision does not protect women.  There has been enough literature, media attention, and so on to see that male circumcision has been a hot topic over the years.  My interest is not to disagree with the argument that male circumcision can, to a degree, reduce the risk of contracting HIV for that man.  In fact, I support the idea of disseminating information and making male circumcision more accessible in Southern Africa.  That is as long as the reduce aspect is thoroughly emphasized as male circumcision does not eliminate risk, the potential side effects are conveyed, and it is not an imposed procedure.

The questions I do wish to raise concern the lengths that are being taken to scientifically prove the relationships between black African male circumcision and HIV risk for black African men and women.  And relatedly, the potential for unintended consequences when the path followed is such a rigorous and relentless insistence on absolute, detailed quantitative scientific proof.  My overall concern is this. The Plus News headline I mentioned could just as easily read: Clinical trial comes to an end, 25 women contracted HIV.  When I think about that alternative headline, my mind goes a couple directions. For all the big money that was spent on the trial, perhaps the money would have been better spent trying to ensure the 25 women (and others) did not contract HIV.  And further, if the majority of men in the US were uncircumcised would the funders of scientific trials have the same comfort-level to round up some HIV-positive men, along with their HIV-negative female partners, and engage them in a trial knowing that some percentage of those HIV-negative American females will end up HIV-positive.  I suspect not.

There are several things I’m getting at here, which relate to my uneasy feelings about trials concerning male circumcision in general and also the particular trial in Rakai District (Southern Uganda) highlighted in Plus News.  Firstly, as part of the effort to scientifically prove that male circumcision reduces HIV risk, a trial immediately offers some men access to the procedure while others must wait until the study is completed.  Secondly, in order to get the scientific proof, along the way, some of the subjects have to become HIV-positive.  Thirdly, the scientific proof for the Rakai District trial is, to a degree, based on 159 Ugandan women honestly reporting that they had sex only with their partner over the trial period. Those three points raise a complicated set of ethical and methodological questions.  Before I go any further, let me outline some of the parameters concerning the Rakai District trial as highlighted in the Plus News article (which draws on two articles in the 17 July 2009 issue of Lancet).

The two-year trial included 922 HIV-positive male subjects.  At the start, 474 were circumcised, and the other 448 were not. Additionally, the trial included 159 HIV-negative female subjects, the partners of a subset of the 922 male subjects.  There were 92 couples representing an HIV-positive circumcised male with an HIV-negative female partner.  And 67 couples representing an HIV-positive uncircumcised male with an HIV-negative female partner.  The couples were basically told to go about their lives, and involvement in the trial importantly provided a range of STI/HIV-awareness services participants might not have otherwise accessed (albeit likely intensely biomedical oriented awareness services).  Follow ups were made at six-month intervals to ascertain if any of the 159 female subjects had acquired HIV from their male partners.   Of the 92 couples involving a circumcised male, 18% (or 17 women) tested HIV-positive.  Of the 67 couples involving an uncircumcised male 12%
(or 8 women) tested HIV-positive.  Thus the conclusion, male circumcision does not reduce HIV risk for women.  I know this is not exactly the case, but still.  In a certain way one result of obtaining that scientifically proven conclusion is that 25 Ugandan women became infected.  The researchers do not state as much directly, but do hint at this possibility.  A number of the circumcised male subjects did not follow the advice to abstain from sex for six weeks following being circumcised (to let the wound properly heal).  When that advice was not followed this was the window in which a greater number of women contracted HIV from their male partners.  Thus an argument can be made that had the men not been circumcised their female partners would not have become HIV-positive.

I know many won’t like what I am writing.  The trial itself did not infect 25 women.  The trial itself was administered by a team of experts and was approved by numerous Ugandan and American ethical review boards.  Additionally, many would tell me the advancement of scientific knowledge has always involved unintended consequences.  And those consequences have to be put in the perspective of the greater good.  But when it comes to clinical trials around male circumcision among black Africans, there are some particular and unique dynamics that don’t sit well with me.  Particularly, when these types of trials are put in the bigger picture, I can’t help but wonder about the notion of engaging black Africans to be subjects for the advancement of scientific research when it is predominantly the Western world wanting to pursue said research.  And ask.  Are there multiple
(conflicting) ideologies at work in making the foreskin of a black African penis a form of difference that warrants scientific study?

To return to my earlier wording, the lengths that are being taken to scientifically prove.  Awhile back, within a listserv discussion, I commented that I am frustrated by the trends PEPFAR, the Global Fund, Bill and Melinda Gates, etc. have ushered in, they are not entirely new, but it seems they are with such greater force than ever before. This incessant demand to prove things, particularly quantitatively. To my mind, and I’ll be blunt.  Enough with the proof around male circumcision.  It’s not a quantitative contest.  I would argue that enough clinical trials around male circumcision have been conducted. It is now time to continue on with integrating the results into long-standing HIV/AIDS information dissemination and service provision efforts.  Specifically along three lines:  1) Male circumcision reduces, but does not eliminate, HIV risk for men; 2) Male circumcision, like nearly all medical procedures, contains risks and requires post-operative care; and 3) Male circumcision is a possible option for informed/consenting adults.

A gender advocacy group is trying to shove self-righteous coolade down Julius Malema’s throat on allegations of hate speech. The ANCYL President is understood to have suggested that Zuma’s alleged rape victim enjoyed the sex because if she hadn’t, she wouldn’t have waited until the sun came out, had breakfast and asked for taxi fare. In my mind I am thinking, ok, what are the prescribed behavior patterns for rape victims? Obviously the youth leader who is coming across more as Zuma’s naïve lackey has no understanding or comprehension of the complexities of rape. Well, whether or not that woman did her things in that neat order the most striking thing is that imbeciles like Malema are left to lead the youth in South Africa. Surely political lapdogs like him are a liability to democracy and ought to be exterminated or locked up before they breed.

Speaking of locked up, the ZLHR today organized a workshop that sought to promote the rights of prisoners in Zimbabwe. Several presentations were made that showed that evidently, the state of or prisons is worse than abandoned dog kennels. Prisoners are hungry and walk around next to naked. Sexual and physical abuse is rampant and disease is claiming a lot of them in droves. The most touching were two things – mothers with little babies are locked up in there and have to share whatever meals they get with their children. There are no separate portions for the kids.

When the mothers menstruate, they have to use pieces of blankets for pads. Secondly; juveniles who have committed petty crime (although in my books there is nothing like that) are thrown together with hardened criminals who instantly turn them into wives, so to speak. At the end of a session, I found I wasn’t the only one struggling with indecision faced with the moral need to provide basic human rights to prisoners and the thought that a lot of them actually are hardcore criminals who have raped, robbed and killed our kith. The workshop continues tomorrow but for now I thought to myself, if Malema was to spend just one night at Chikurubi, I couldn’t give a rat’s ass if he starved.

Some people argue that no one really uses them ‘in the heat of the moment’. Others say they just don’t like the artificialness that they bring to what should be a ‘natural’ experience – sex. “It’s like eating a sweet with its wrapper still on, or an unpeeled banana,” so they say.

But like them or hate them, use them or avoid them, the possibility of not having condoms at all as an HIV prevention option is a very serious issue with very real implications for those who do choose to make use of them.

And if recent reports from South Africa of condom stock-outs in the Free State province’s public hospitals are anything to go by, the likelihood of such an occurrence is more real than one might want to imagine.

In an article carried by the PlusNews HIV analysis service, it was revealed that some South African clinics are reporting complete condom stock-outs owing to what a Treatment Action Campaign (TAC) representative described as a severe shortage of human resources, as well as weak distribution networks and budget shortages.

These stock-outs obviously violate a basic human right – the right to health, and its various options. For, much as their use and comfort may be debated, condoms constitute an impotent component towards realising the sexual and reproductive health rights of all people. Not having access to them limits one’s health options in a similar way that not having access to ARVs (if one is HIV positive and in need of them) does.

Yet with condoms costing much less to produce than ARVs, it is simply much more affordable – for governments, donors, non-profit and commercial sectors – to prevent, rather than treat HIV.

For this reason, and the ones to follow, stock-outs are completely unacceptable.

The next reason to bear in mind is that condoms play a dual prevention role in that they can be used to both prevent pregnancies, as well as to prevent  transmission of HIV and STIs. According to the United Nations Population Fund (UNFPA), of an estimated 10.4 billion male condoms used worldwide in 2005, around 4.4 billion were used for family planning and 6 billion for HIV prevention.

But their efficacy is premised upon correct and CONSISTENT use, which is why stock-outs in the public health care sector present such a major challenge to sexual and reproductive health efforts. It is indeed a tragedy that many of the countries with the highest global HIV prevalence rates harbour some of the world’s poorest communities who cannot afford to purchase condoms and therefore rely solely on those that are freely provided, or sold to them at subsidised prices. For these people, stock-outs spell danger because while condoms may still be available to them via the private sector (such as supermarkets and pharmacies), the commercial brands sold there would be far too expensive, and therefore beyond their financial reach.

What stock-outs essentially mean is that people could become infected not through a lack of knowledge, but perhaps largely through a lack of financial resources to purchase prevention tools.

Nobody equipped with information about HIV and AIDS today should become infected, or re-infected. Nobody should have to seek out means of prevention and fail to find them, especially at a time when the theme around prevention is becoming evermore-dominant in global discourse around the HIV pandemic.

Stock-outs of condoms should never happen. It is too blatant a theft of one’s rights to sexual and reproductive autonomy.

Effective planning and budgetary allocation of funds towards procurement of sufficient quantities of condoms should be carried out by all governments and key stakeholders to prevent any shortfalls in supply. This should be bolstered by regular monitoring and evaluation of trends in sexual behaviour and activity of populations. This is crucial  for as people begin to engage in sexual activity at an ever-earlier age, as well as learn about the dual efficacy of condoms (as discussed earlier), and also disregard previously held misconceptions about them, it follows that demand for condoms will rise. Supplies based on the sexual habits of a population five or ten years ago will not suffice.

And nor will moralistic debates pitting abstinence as ‘good’ against pre-marital sex as its ‘evil’ opponent.

Governments must also put in place policing measures to ensure against corruption in the supply and distribution chain of condoms to public health facilities. While it is well acknowledged that theft and other forms of corruption take place in the supply and distribution of the more lucrative essential medicines (such as ARVs and painkillers), it is important to investigate if the same underhand dealings are also taking place with condoms.

Ultimately, the argument presented here is not about what people do – or should do – with condoms. It is simply about equipping them with the option to choose.

It is the dry season
the time of seed bearing
when pod-laden trees
rustle in cold northern winds
singing the potential of new life
to the clear blue winter skies

Now is the time to call back the sun

The tree of life team were invited to a far corner on the eastern border mountains of Zimbabwe
where a chief and the people of his clan live on the steep sides of a fertile valley
the mountain that holds the graves of 4 generations of chiefs
the people of the Flying Ant totem
Chikukwa

The place of an ancient mountain crossing
a path where ‘one-by-one’
people journey back and forth to Mozambique
- for ancient paths pay little respect to political boundaries.

Over the last 25 years a shift of energy has entered this valley
the abundant water held in the body of the mountain
has been channelled to each thatched homestead
and swathes built along contours, and permaculture, and rotation farming and tree planting
has restored the land
they are surrounded by sugar cane and bananas and rape and lettuce of every kind and beans and peas and pawpaws and tomatoes and sweet potatoes and maize and herbs of every kind

They have looked at conflict resolution
and HIV/AIDS
The responsibility of sharing
and the sharing of responsibility
and of community caring for orphans and elders
They have looked at culture and spirit and meditation
and called forth the essence  that is needed to hold them in place
with dignity
A place where peace is being made with land
and between the 6000 people who live there

We travelled with representatives from the two urban communities
Epworth and Whitecliff – who have been battered and beaten
grass roots to grass roots
a sharing of what life has been
and what life can be

We did the Tree of Life circles with community
and they spoke of old unspoken wounds from their childhoods
of old hurts and the need to repair damage in their families
“I never thought I could tell of happened to me when I was a child”
one elderly woman said
“I thought I would be a laughing stock
but now I have said it, and I was heard, and I am free of that old pain”

The old man
bent knees,
clouded wise eyes
brother of the chief who has been the leader of the people
takes the stone in the circle
“the lessons you have brought us will stay in our hearts
our people will grow”

And the lessons of these remote people
of their courage, and openness, and their work towards peace and their love of their land
are lessons that will stay in our hearts

The seeds are sown
may they grow.

“I’ve never come out of the closet because I’ve never been in it,” says Dirk Slater of his openness as a homosexual man. Growing up in California, in the United States of America, Slater says that he was always comfortable and conscious of his gayness and was never pressured to make an effort to conceal it. He was in his teens when the first cases of Karposi’s sarcoma – the first known symptom of what was later to be termed AIDS – were observed among American homosexual men in, 1981. At this time, homosexuality was heavily stigmatised and seen as the cause of this outbreak. “It was a scary time,” confesses Slater, now 44. “There was this gay cancer going around and a lot of people died from it, including my own friends.” Yet even through all that fear and lack of understanding, Slater was able to live openly as a gay man. “If you are in a big city (like California), it’s usually okay,” he says of the prevailingly tolerant environment that large cities offer to people with alternative sexual preferences in the US. “A gay couple can often show public affection and not get into trouble for this, but this is not the same in smaller towns.”

And it is usually not the same in other countries where homosexuality is openly condemned and criminalised. In some parts of the world, penalties against homosexual practice are as extreme as the death penalty. And while efforts have been made to decriminalise homosexuality, globally, same-sex couples do not often enjoy the same rights as heterosexual couples. In many countries, gay partners can neither marry legally nor adopt children.

South Africa, however, shows signs of change and optimism for the homosexual community. In 2006, South Africa became the first African country to give same-sex couples the right to marry. The Civil Union Act – the piece of legislation passed to endorse this – offers gay couples the same rights and recognition as heterosexuals.

But, as Sally-Jean Shackleton, Executive Director of Women’s Net, a South African gender NGO, points out, “There is positive legislation but the negative side of this is that in practice, the lives of those who challenge the binary construct of gender are still very much in danger.”

Along with facing acts of violence, Shackleton feels that lesbians, gays, bisexuals, transgender and intersexual people (or LGBTI) are often marginalised in HIV programming. “Only LGBTI groups are driving the process,” she states, citing examples of the unavailability of dental dams – for protection during oral sex between women – as a way that the HIV protection needs of lesbians were not being met.  Dental dams are thin, square pieces of latex that are used for oral-vaginal or oral-anal sex and are also usually used in dental procedures, hence their name. “Men can protect themselves with condoms but the same is not true for women.”

Shackleton also states the fact that mainstream healthcare providers are often not places where LGBTI can get information on HIV prevention tools that suit their needs. Also, the double stigma of being termed sexually non-conformist, as well as HIV positive, is noted as a deterrent for many in seeking HIV prevention, treatment, care and support options. “People are afraid to be visible,” adds Slater. “It’s ten times harder to come forward if you are HIV positive and homosexual, at the same time.”

Amy, not her real name, is a 24-year old Lebanese woman who echoes Shackleton’s sentiments. “Society tends to classify LGBTI all the same,” she says. This, she feels generalises the different issues they face individually, and does not adequately address the specific needs and services that they require.

Amy classifies herself as ‘queer’ and says that for herself, there is no such concept as being a man or a woman. As such, she does classify herself, or her sexual preferences, by this dual system.

“People see us as perverts and think that they need to ‘heal’ people like me and others, by correcting us through hormone injections or a sex change,” adds Amy.

Slater mentions that homosexuals also tend to be commodified as ‘wedges’ used in electoral campaigns to either win or lose votes. “(George) Bush used the fact that candidates like (Al)Gore and (John) Kerry were tolerant of homosexual issues as a way to scare away conservatives from voting for them,” he states of the previous US president’s election campaigns.

It is thus respect for different beliefs, as well as enactment and implementation of enabling legislation that Slater, Shackleton and Amy all wish for. “We need to support alternative ideas around masculinity and promote alternative role models as a means of creating an enabling environment for all to freely express themselves,” says Shackleton.

“Governments need to stop being stupid!” states Slater. “And cultures need to stop ostracising people who are different. “