The Pope and his merry gang are tying themselves in knots again about things they know little of. They are not experts in sex, only in denying that it occurs. Outside of ostentatiously religious circles, sex is just one type of human behavior, it's certainly not an act of gross immorality. It's a highly significant type of human behavior, but it dates back long before Christians decided to prognosticate about it.
If I was sick, suffering from any disease, HIV being just one, I certainly wouldn't ask the Pope's advice on how to live my life, how to avoid transmitting the disease, etc. And if I wanted to avoid HIV, or any other disease, I wouldn't aks the Pope for advice either. Because the advice I would get would be wrong.
Not that the advice you'd get from UNAIDS or many other institutions would be any better. They would all lecture you on sex, safe and unsafe, and they would probably tell you that no sex at all is the best thing. But not having sex will not protect you from HIV, especially in high prevalence countries. And practicing safe sex will not either.
Time after time, research has shown that people who have no sex or no unsafe sex are as likely to be HIV positive as those who have lots of sex or have unsafe sex most of the time. Sometimes, they are even more likely to be HIV positive. The connection between HIV and sex is tenuous.
This is not to say the connection does not exist. Certain kinds of sex are very dangerous, such as anal sex. Certain sexually transmitted infections (STI), very common in some countries (developing and developed), highly transmissable infections, increase the risk of transmitting or of contracting HIV. But the probability of transmission through heterosexual sex is generally low.
True, STIs can be very common in some African countries. But exceptionally high rates of easily treated sexually transmitted diseases is not a sign that people there have lots of sex, or lots of unsafe sex. It is a sign that the health services are in disarray. Many people hardly ever visit a health facility and many of those who do are as likely to be infected with something they don't already have as be cured of something they do have.
In addition to the risk of being infected with HIV and other diseases in hospitals and other health facilities, people even face risks if they go to a hairdresser, a tattoo artist or a pedicurist. UNAIDS and other institutions who are obsessed with others having sex don't want to admit it but these are far more efficient transmitters of HIV than sex.
Tanzania is, according to some figures, roughly divided into three in terms of dominant religious. About one third each are Muslim, Catholic or some kind of non-Catholic Christian. HIV rates are often (though not always) lower among Muslims. But rates are very similar among the other two religions.
Similar remarks apply to Kenya and some other countries. For all their posturing, Christians, Catholic or otherwise, are no less likely to be HIV positive, to suffer from high rates of other STIs, to engage in sexual behavior considered to be unsafe, to circumcise their daughters, to beat their wives and generally indulge things that are considered to be 'unchristian'.
The fact is, many people say the right things, or what they consider to be the right things, but they do just what they want to do. So shouting about whether condoms and contraception are wrong or right, for most people, is hypocritical and potentially dangerous. There is a vast unmet need for contraception among women in developing countries.
These 'Christians' would be better advised to figure out how to change the kinds of behavior that results in some of the worst social and development problems. They could even spend a bit of time considering how to reverse the levels of gender inequality that they have spent centuries building up because that is behind some of the biggest threats that people face, especially women, mothers and girls.
Every time an article like this is published, the irrelevance of Popes, priests and religions are shoved down our throats. But when these people and institutions stand by while others become infected with a debilitating and deadly disease, it's time to tell these overfed fools where to stuff their advice. If I thought the churches had something valid to say about morality, I might listen, but they don't.
Showing posts with label child mortality. Show all posts
Showing posts with label child mortality. Show all posts
Saturday, January 22, 2011
Sunday, May 17, 2009
The Money Follows the Hype
I was reading a social and economic profile of the area I’m currently visiting, Isiolo, in Eastern Province, Kenya. Close to the end of the profile, it was stated that donor funding is usually followed by government development funding. Therefore, the development priorities of donors strongly influence the priorities of the Kenyan government. Anything not considered a priority receives very little funding from donors, but also from the government.
This leads to the ridiculous situation where far more children, mainly in developing countries, are dying from diarrhoeal diseases than from HIV, TB and malaria combined. Yet only $1.5bn was spent on developing water and sanitation in the years 2004-2006. In the same period, $10.8bn was spent on HIV/Aids. 1.8m children worldwide died of diarrhoea whereas only around 300,000 children died of HIV/Aids.
I want to draw attention to two separate issues here (without wanting to suggest that they are the only two issues!): there is the problem of donors fixating on certain problems and throwing huge amounts of money at interventions that often have little effect; then there is the issue of governments in countries like Kenya failing to target their most serious problems.
I think I can see why donors are so interested in HIV/Aids to the exclusion of almost anything else. They are often led by a powerful media and a powerful public that is also led by a powerful media. Being cool, up to date, with it, sexy, whatever the current term is, these are more important than any real issue. The mere fact that people are sick and dying is irrelevant.
But this doesn’t excuse governments from duplicating the work of donors by adopting the same priorities. Surely they see the many other far more pressing problems that are facing people every day? The fixation on HIV/Aids distorts the way countries allocate funding, it distorts the work that is carried out in the name of development and it distorts the way developing countries allocate their scarce financial resources. There is a distinct lack of autonomy and accountability here; why should an electorate accept the fact that foreign owned institutions with single and narrow interests have far more influence on their lives than their own governments?
HIV/Aids is just one disease of many and one sexually transmitted infection of many. Water and sanitation, in contrast, is vital to life. Diarrhoea is not a disease, it is a symptom, just one symptom of numerous conditions, many of which are caused by a lack of access to clean water and safe sanitation. If wealthy governments and NGOs want to address the most pressing issues they shouldn’t have far to go to find them. But it is not acceptable for them to just react to what is cool in the world of media, hype and political posturing.
Of course HIV/Aids is important, it’s just that people won’t live long enough to be infected or, if infected, they won’t live long enough to die from Aids if they don’t have other things such as adequate nutrition, water and sanitation, basic health and education and many other social services. Fighting HIV/Aids depends on developing countries having the capacity to provide these services first; they are not just optional extras or issues that can be dealt with later.
It’s true that we can’t easily solve the world’s major problems, such as hunger, poverty, lack of social services, disease, inequality, etc. But that doesn’t mean we should do nothing. Some of the money that now goes into dubious HIV prevention programmes could wipe out cholera in many countries, thus massively reducing mortality among children and infants. A fraction of the money that is being wasted on unproven agricultural technology, such as genetically modified organisms, could provide a sustainable solution to food shortages in many countries. The tens of billions that are proposed to fund the provision of one laptop to every child in developing countries could save several thousand children’s lives every day for the foreseeable future.
An estimated 10 million young children die every year from poverty related problems. These are serious problems and they will not go away soon. But there is a lot of money and capacity being wasted on things that are not nearly as urgent. No one would be stupid enough to spend all their money on HIV education for a child that is dying or may die of cholera or something equally easy to prevent or cure. We need to get away from the politics and media hype surrounding HIV/Aids and see that some of the problems people face in developing countries are much more basic and not quite so intractable.
This leads to the ridiculous situation where far more children, mainly in developing countries, are dying from diarrhoeal diseases than from HIV, TB and malaria combined. Yet only $1.5bn was spent on developing water and sanitation in the years 2004-2006. In the same period, $10.8bn was spent on HIV/Aids. 1.8m children worldwide died of diarrhoea whereas only around 300,000 children died of HIV/Aids.
I want to draw attention to two separate issues here (without wanting to suggest that they are the only two issues!): there is the problem of donors fixating on certain problems and throwing huge amounts of money at interventions that often have little effect; then there is the issue of governments in countries like Kenya failing to target their most serious problems.
I think I can see why donors are so interested in HIV/Aids to the exclusion of almost anything else. They are often led by a powerful media and a powerful public that is also led by a powerful media. Being cool, up to date, with it, sexy, whatever the current term is, these are more important than any real issue. The mere fact that people are sick and dying is irrelevant.
But this doesn’t excuse governments from duplicating the work of donors by adopting the same priorities. Surely they see the many other far more pressing problems that are facing people every day? The fixation on HIV/Aids distorts the way countries allocate funding, it distorts the work that is carried out in the name of development and it distorts the way developing countries allocate their scarce financial resources. There is a distinct lack of autonomy and accountability here; why should an electorate accept the fact that foreign owned institutions with single and narrow interests have far more influence on their lives than their own governments?
HIV/Aids is just one disease of many and one sexually transmitted infection of many. Water and sanitation, in contrast, is vital to life. Diarrhoea is not a disease, it is a symptom, just one symptom of numerous conditions, many of which are caused by a lack of access to clean water and safe sanitation. If wealthy governments and NGOs want to address the most pressing issues they shouldn’t have far to go to find them. But it is not acceptable for them to just react to what is cool in the world of media, hype and political posturing.
Of course HIV/Aids is important, it’s just that people won’t live long enough to be infected or, if infected, they won’t live long enough to die from Aids if they don’t have other things such as adequate nutrition, water and sanitation, basic health and education and many other social services. Fighting HIV/Aids depends on developing countries having the capacity to provide these services first; they are not just optional extras or issues that can be dealt with later.
It’s true that we can’t easily solve the world’s major problems, such as hunger, poverty, lack of social services, disease, inequality, etc. But that doesn’t mean we should do nothing. Some of the money that now goes into dubious HIV prevention programmes could wipe out cholera in many countries, thus massively reducing mortality among children and infants. A fraction of the money that is being wasted on unproven agricultural technology, such as genetically modified organisms, could provide a sustainable solution to food shortages in many countries. The tens of billions that are proposed to fund the provision of one laptop to every child in developing countries could save several thousand children’s lives every day for the foreseeable future.
An estimated 10 million young children die every year from poverty related problems. These are serious problems and they will not go away soon. But there is a lot of money and capacity being wasted on things that are not nearly as urgent. No one would be stupid enough to spend all their money on HIV education for a child that is dying or may die of cholera or something equally easy to prevent or cure. We need to get away from the politics and media hype surrounding HIV/Aids and see that some of the problems people face in developing countries are much more basic and not quite so intractable.
Saturday, January 17, 2009
The Right to Trivia
On Friday the 9th of January, newspapers announced that the government was warning that up to 3 million people faced starvation because of growing food shortages. That's more than 10% of the population. By the following monday, the number had risen to 10 million, in excess of 25% of the population. There was no analysis of why the figures had changed so profoundly.
Yesterday, Friday the 16th, famine was not to be found, unless you count passing references in articles on unrelated matters. There is mention of millions facing starvation on page 6 of The Nation in an article on senior politicians spending large amounts of public money on a trip to the inauguration of the president of a foreign country. These politicians were not invited so taxpayers (which doesn't include politicians, because they don't pay tax) are going to pay for an expensive trip to watch the event on TV.
Perhaps they don't trust their own media to cover the event adequately. Their own media is far more interested in signs of disagreement in the coalition government. That's front page news today. After all, these signs of disagreement are so hard to discern, right? There is a a small amount of interest in various scandals that involve various politicians and other senior public figures but interest in these is currently waning.
But there is little interest in the matters that affect individual people, especially poor people. For example, why do water supplies only reach wealthier neighbourhoods and where does the water sold to poorer people at such high prices come from? Where did all the recently imported maize, intended to avert famine, go to? What has been happening to fuel that has been distributed to outlets, allegedly, but doesn't seem to have reached them?
One quarter of the country's population facing starvation didn't make the front page today. Nor did the fact that child death rates are up, again. Child death rates have been rising almost constantly since the 1980s, so this is not a recent trend. It's a trend that cannot be blamed on the HIV epidemic, the water, fuel or food crisis, global warming or any other issue. There is a long running crisis in health, education and other social services.
Of course, it's difficult to assess figures like those from the UN 2009 State of the World's Children report, showing that 121 out of every 1000 live births recorded result in death, mostly in the first year of a child's life. Difficult to assess because an estimated 40% of births are not recorded. The figure could higher or lower but it's difficult to know how many births have not been recorded!
It's not that political wranglings are not important or that the coalition shouldn't be urged to settle their differences and start running the country, these are important. But it's because of their failure to run the country that child mortality and maternal mortality figures, to name but a few, are so high. It's because of the government's failures that people are starving, have no water, are dying of preventable diseases.
Behind the shortage of maize, in addition to the cartels that may or may not exist, there are government plans to sell and/or lease land so that foreign countries can grow sugar for biofuels and food crops for their own people. This is land that is currently farmed by Kenyans or, at least, owned by Kenyans. It could be used to grow food.
The government says it is building a port in Lamu with the money they make from the land. This port will take many years to build, as Raila Odinga reminded us when he gave a figure of five years for enhancements to Mombasa Port.
So what's wrong with using the land to grow food that should be available after one season? In five years time, if the port is really built, will Kenya have any money left to import anything through a new port in Lamu?
More importantly, how many people will have died, unnecessarily, by the time this 'vital' port is built? Water and food cannot wait till political wranglings are sorted out. These wranglings, in many cases, date back to the earliest days of the Kenyan Republic. Death from lack of water and food is very fast. Some will already have died by the time the politicians who went, uninvited to party in the US, have returned.
It's not politicians who die in civil unrest, famine or epidemics; politicians children don't die of preventable diseases and their wives don't usually die in childbirth. They are completely divorced from the pain, although they may see it all on TV. That's if the media bothers to cover it. And if they are not watching US TV, in the US.
The press who appealed so recently to the electorate to protect them from government excesses is now little moved by the plight of ordinary Kenyans. Millions of people facing starvation and children dying in large numbers should be front page news, so should reportage covering what the government intends to do about it. And when the government says what they intend to do, their actions need to be followed until they show some result. Why is the press so obsessed with triviality?
Of course, government wranglings can turn to riots and many lives can be lost. But far more people die from malnutrition, starvation, water shortage, preventable disease and various other things than from civil distrubances. When these issues have been resolved there will be time enough to cover the many political farces but meantime, perhaps the press will reconsider its priorities.
Yesterday, Friday the 16th, famine was not to be found, unless you count passing references in articles on unrelated matters. There is mention of millions facing starvation on page 6 of The Nation in an article on senior politicians spending large amounts of public money on a trip to the inauguration of the president of a foreign country. These politicians were not invited so taxpayers (which doesn't include politicians, because they don't pay tax) are going to pay for an expensive trip to watch the event on TV.
Perhaps they don't trust their own media to cover the event adequately. Their own media is far more interested in signs of disagreement in the coalition government. That's front page news today. After all, these signs of disagreement are so hard to discern, right? There is a a small amount of interest in various scandals that involve various politicians and other senior public figures but interest in these is currently waning.
But there is little interest in the matters that affect individual people, especially poor people. For example, why do water supplies only reach wealthier neighbourhoods and where does the water sold to poorer people at such high prices come from? Where did all the recently imported maize, intended to avert famine, go to? What has been happening to fuel that has been distributed to outlets, allegedly, but doesn't seem to have reached them?
One quarter of the country's population facing starvation didn't make the front page today. Nor did the fact that child death rates are up, again. Child death rates have been rising almost constantly since the 1980s, so this is not a recent trend. It's a trend that cannot be blamed on the HIV epidemic, the water, fuel or food crisis, global warming or any other issue. There is a long running crisis in health, education and other social services.
Of course, it's difficult to assess figures like those from the UN 2009 State of the World's Children report, showing that 121 out of every 1000 live births recorded result in death, mostly in the first year of a child's life. Difficult to assess because an estimated 40% of births are not recorded. The figure could higher or lower but it's difficult to know how many births have not been recorded!
It's not that political wranglings are not important or that the coalition shouldn't be urged to settle their differences and start running the country, these are important. But it's because of their failure to run the country that child mortality and maternal mortality figures, to name but a few, are so high. It's because of the government's failures that people are starving, have no water, are dying of preventable diseases.
Behind the shortage of maize, in addition to the cartels that may or may not exist, there are government plans to sell and/or lease land so that foreign countries can grow sugar for biofuels and food crops for their own people. This is land that is currently farmed by Kenyans or, at least, owned by Kenyans. It could be used to grow food.
The government says it is building a port in Lamu with the money they make from the land. This port will take many years to build, as Raila Odinga reminded us when he gave a figure of five years for enhancements to Mombasa Port.
So what's wrong with using the land to grow food that should be available after one season? In five years time, if the port is really built, will Kenya have any money left to import anything through a new port in Lamu?
More importantly, how many people will have died, unnecessarily, by the time this 'vital' port is built? Water and food cannot wait till political wranglings are sorted out. These wranglings, in many cases, date back to the earliest days of the Kenyan Republic. Death from lack of water and food is very fast. Some will already have died by the time the politicians who went, uninvited to party in the US, have returned.
It's not politicians who die in civil unrest, famine or epidemics; politicians children don't die of preventable diseases and their wives don't usually die in childbirth. They are completely divorced from the pain, although they may see it all on TV. That's if the media bothers to cover it. And if they are not watching US TV, in the US.
The press who appealed so recently to the electorate to protect them from government excesses is now little moved by the plight of ordinary Kenyans. Millions of people facing starvation and children dying in large numbers should be front page news, so should reportage covering what the government intends to do about it. And when the government says what they intend to do, their actions need to be followed until they show some result. Why is the press so obsessed with triviality?
Of course, government wranglings can turn to riots and many lives can be lost. But far more people die from malnutrition, starvation, water shortage, preventable disease and various other things than from civil distrubances. When these issues have been resolved there will be time enough to cover the many political farces but meantime, perhaps the press will reconsider its priorities.
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