The global health problem that I chose to discuss is HIV in Swaziland. Swaziland is a small country located in Southern Africa where HIV/AIDS has been extremely devastating. At 26%, Swaziland has the highest incidence of HIV worldwide, and with 1 in 4 adults living with HIV, there has been a severe impact on on families. Almost one third of the country are under 14 years old, and 104,026 children are reported to be orphaned or vulnerable. HIV is a huge contributing factor to the low life expectancy of 48.9 years in Swaziland. The first cases of AIDS in Swaziland were said to be reported in 1986, and since then, HIV has spread extremely quickly throughout the small country. There are many factors contribute to the spread of HIV in Swaziland, including social, cultural and political factors. The most important contributing factor to the spread of HIV in Swaziland is the male-dominated culture and social norms. Gender based violence, gender preference and gender inequality are extremely prominent in Swaziland. Sexual behaviour in Swaziland encourages the spread of HIV because Swazis believe that it a woman’s duty to almost continually bear children and that it is a man’s duty to impregnate multiple women. This leads to the vulnerability of women, and a low rate of safe sex and monogamy, which increase the risk of HIV infection. There are a few things that are being done to address the prevalence of HIV in Swaziland, including behaviour change programs, increased HIV testing, and important action by the Swaziland government. Swaziland’s Ministry of Health has recognized the issue of gender inequality, and in 2011, they developed a framework to ensure access and treatment to at risk groups, such as women. Swaziland is also currently 1 of 5 sub-Saharan countries to achieve the goal of getting 80% of eligible people on antiretroviral treatment, thus reducing the number of HIV/AIDS related deaths. There are also numerous NGOs, such as The Swaziland AIDS Support Organisation and The AIDS Support Centre, that are contributing funds and resources to help address the problem.
Anthropologist Justin R. Knox, wrote an article called “Exploring the potential for a culturally relevant HIV intervention project: a Swaziland example”, that was published in Anthropology & Medicine. In his article, he describes a project that was aimed at engaging traditional Swazi healers in order to conceptualize HIV within traditional Swazi beliefs and culture. His study addresses the benefits and challenges of attempting to unite biomedical intervention and traditional healing to create a culturally relevant HIV intervention project. Unfortunately, he was not successful at developing a culturally relevant HIV program, but he was able to obtain a lot of information about Swazi healing beliefs that could be helpful in the future. He found that it was often extremely difficult to collaborate with the traditional Swazi healers because they highly valued traditional Swazi healing beliefs, although they did show some indication that they would like to collaborate for some financial support. Knox was also able to discover that traditional healers feel that collaborative efforts have been imbalanced, with biomedicine being favoured. Knox was able to indicate that an ethnographic approach is the most likely to result in a successful collaboration with the Swazi healers and the has the most potential to enhance current typical HIV intervention models. Ultimately, with continued research, Knox hopes that a successful locally-adapted HIV prevention model for Swaziland may be developed.
“HIV & AIDS in Swaziland.” Advert. Accessed August 7, 2104.
Knox, Justin R. “Exploring the Potential for a Culturally Relevant HIV Intervention Project: A Swaziland Example.” Anthropology & Medicine 17, no. 1 (2010): 87-98. http://www.tandfonline.com.proxy2.cl.msu.edu/doi/full/10.1080/13648471003607615#tabModule
“NGOs Lead in the War against AIDS.” News From Africa. January 1, 2002. Accessed August 7, 2014. http://www.newsfromafrica.org/newsfromafrica/articles/art_852.html.
“SWAZILAND: A Culture That Encourages HIV/AIDS.” IRIN Africa. April 15, 2009. Accessed August 7, 2014. http://www.irinnews.org/report/83937/swaziland-a-culture-that-encourages-hiv-aids.