HIV/AIDS in Swaziland

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.

This Post Has 2 Comments

  1. Naomi Fleischmann says:

    When anthropologist John R. Knox researched the prevalence of HIV in Swaziland, he had to take the ethnomedical approach to medical anthropology because of Swaziland’s strong beliefs in their healers. Knox had to work with the healers in Swaziland because they were the ones that would have the biggest influence on the possible HIV intervention plan. The people of Swaziland look to their healers for medical advice and were not likely to listen to an outsider’s point of view unless their healers agreed with the outsider. Knox realized that his plan to come to Swaziland and almost immediately lower the spreading rate of HIV was not going to happen. He did realize though that he had something valuable to the healers: money. Swaziland is not a financially sound area, and therefore Knox was able to help them in that specific area. Knox also realized that the healers were not fond of the idea of combining their healing methods with biomedicine because in the past they believed that biomedicine had outweighed their traditional healing methods. I believe that had an anthropologist not gone to Swaziland, the people of the world would not be able to understand why HIV is so prevalent there and why no one is doing anything to stop it from spreading. Thanks to Knox’s new understanding of their culture one realizes that even though it would normally make sense to start the Swazi people on medication, it would be pointless to send the medication to Swaziland because it simply will not be used due to their cultural beliefs. Perhaps one day Swaziland will come to terms with their strong need for medication, but for now they are not too keen on the idea of help from anyone but their healers.

  2. Amber Roberts says:

    To me, it seems that anthropologist John R. Knox took the ethnomedical approach when studying the prevalence of HIV in Swaziland. In Swazi culture, people seek medical treatment from traditional healers whose role is to find the cause of misfortune or disease, prescribe actions to rectify it, and prepare medicine to cure illness. Because the people of Swaziland had strong cultural beliefs tied to the healer, Knox realized that the people would not follow any of his medical advice unless the healer had approved. For this reason he developed a project aimed to conceptualize HIV within traditional Swazi beliefs. His plan was to unite biomedicine with traditional healing to create a culturally relevant HIV program.

    Analyzing this global problem through an anthropological viewpoint allows us to better understand the cultural aspects affecting health care. From an outside perspective, it is hard for people to understand why the incidence of HIV is so high in certain regions such as Swaziland, and why no one is doing anything to stop its spreading. But from an anthropologists view we can see that there is a reason why Swazi people are not taking medication to stop the spread and that is due to their cultural beliefs. In their culture, they get medical advise from traditional healers, so they will more than likely disregard the medicine that an outsider has given them. This is similar to the situation in which villagers were taught to clean their water through boiling. Though they learned how to boil water, they did not implement the practice because it went against their cultural beliefs. These are just a couple of examples of how an anthropological views offer us a better understanding of medicine and treatment in other cultures.

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