Archive for the ‘HIV-AIDS’ Category

Zimbabwe makes more mistakes: Tell Zimbabwean Politician: “Making Women Less Attractive” Won’t Stop AIDS

May 22, 2012

Hugh Paxton’s Blog is very familiar with insane Black supremacist Zimbabwean politicians and their wildly off the cuff and ill considered opinions expressed in the international forum of debate and scrutiny. This fellow takes things into a new league of irrational and bullying belligerence. Mugabe has a long history of accusing anybody who disagrees with his policies as being part of a gay/British plot to depose him. Utter nonsense of course. His offspring are repeating his mistakes. Every word these ZANU-PF fascists utter makes me cringe.

From: Kathleen J., Care2 Action Alerts []
Sent: 22 May 2012 11:49 AM
To: Hugh Paxton
Subject: Tell Zimbabwean Politician: "Making Women Less Attractive" Won’t Stop AIDS

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Hi Hugh,

HIV currently affects 14.3 percent of adults in Zimbabwe. That means that more than 1 in 6 Zimbabweans suffer from this devastating, wasting disease. But according to politican Morgan Femai, the way to stop the spread of HIV is to make women less attractive.

Tell Femai that this disgustingly blatant misinformation does far more harm than good. »

While talking at an HIV awareness workshop, he said that the government should create a law that forces women to keep their heads shaved. He said that the spread of HIV can be stopped if women shave their heads, stop bathing, and try to make themselves unattractive because it’s hard for men to "resist attractive women."

He also suggested female circumcision — an extremely dangerous practice.

These suggestions on how to fight the spread of HIV are not only harmful, misleading, and dangerous–they take vital attention away from real ways to prevent HIV.

Please ask Morgan Femai to retract his statements about the prevention of HIV immediately. »

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"Making Women Less Attractive" Won’t Stop AIDS
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A Fork in the Road

January 16, 2012

Hugh Paxton’s Blog received the following “Let’s talk about Sex in Africa” story from Michael Boxall, the editor of linked blog Well worth a read!

The opinion piece called A Fork In The Road can be read by clicking the google icon or visiting

A Fork in the Road

STDs Dating Agencies

January 28, 2011

A gentleman asked Hugh Paxton’s Blog if we could provide details of dating agencies catering to people with STDs (in this case Herpes and AIDS).

As usual Hugh Paxton’s Blog had no idea. And as usual Steve Hollier did. Thanks Steve and good luck to the writer. Hope things go well and you find a little love

Read on!


I am sure you knew I would rise to the challenge.

There are plenty out there. Here are a selection:

Rhino Repetition and Impact of HIV-AIDS on Conservation

January 27, 2010

The more astute readers of this Blog will have noticed that identical articles on rhino poaching were posted.



And now for something completely different.

Conservation Threatened by HIV-AIDS

Etosha National Park and the Namib Naukluft National Park are two of Africa’s greatest and most internationally famous protected areas.

Both recently celebrated their centenaries but behind the festivities, commemorative events and speeches there was a skeleton at the feast – HIV/AIDS. While the impacts of the pandemic on the economic sector are well documented it is only very recently that attention has been turned to assessing and addressing the pandemic’s potentially disastrous effect on the future of African environmental conservation.

We invite  Lazarus Nafidi formerly an employee of the Ministry of Environment and Tourism (MET) to address these new concerns.

Lazarus was co-ordinator for the HIV/AIDS Environment Working Group (HEWG). He currently works for Namibia Wildlife Resorts (NWR).


It is dusk in Etosha National Park then, quickly as is the way in my beloved country, it is night. At the waterhole the show begins in earnest.

Animals have been trooping in all day to drink. Zebra, giraffe, kudu, and many more but it is at night that the fur really flies. And the tourists who have come from around the world are thrilled and enchanted by the spectacle of elephants sparring, lions padding in looking for blood, rhinos starting the wildlife equivalent of ‘bar fights’ if anything gets in the way of their next drink…

Maintaining this drama, however, isn’t just down to the animals.

There are a lot of people involved.

These are the MET staff who maintain the national park fences, who fix the waterhole pumps if the gizmos break, the people who are out in the bush on anti-poaching patrols, the people who negotiate with neighbouring farmers if an elephant herd decides to run amok. In short, the guys who make things work.

Without them one of the basic foundations of Nambian prosperity – its protected areas and environment – is in serious trouble.This is one compelling reason why the menace of HIV-AIDS to conservation needs addressing.

Environmental conservation is the cradle of the country’s growth potential and the welfare of its human (and non-human) populations and it is also essential to the growth and health of Namibia’s burgeoning tourism industry.

The key tourist draw is wildlife, wilderness and scenery.

Namibia has all three in extraordinary abundance but to maintain the national parks, yes, we need people, infrastructure and vehicles that don’t spend too much time acting as hearses, taxis or ambulances.

Much of Namibia’s protected environment is administered and managed by the government. In the case of tourism, some responsibilities and benefits have been passed down to rural communities through conservancy schemes which involve local communities and leaders taking responsibility for their land, its wildlife and reaping the benefits of tourist Euros, pounds or rand. The private sector lodges also make great contributions.

Furthermore a large percentage of Namibia’s rural population depends on the natural environment for their subsistence through activities such as the harvesting and collection of firewood, wild fruits and berries, medicinal plants and water extraction.

Managing these resources in a sustainable manner can mean the difference between future generation’s survival and environmental degradation and a national decline.

HIV and AIDS in Namibia

The HIV infection rate in sub-Saharan Africa is relatively high (16.5%) but Namibia perhaps has one of the highest prevalence rates in the whole of sub-Saharan Africa, roughly 19.5%. Regional variations in the prevalence rate are also evident with the natural resource rich north-eastern region of Caprivi recording the highest prevalence rate at 45%. The section of the population hardest hit by the pandemic is the labour force.

Making the linkages

So what are we doing about it? HEWG), is a multi-sectoral committee spearheaded by the Ministry of Environment and Tourism in Namibia to address the linkages between HIV/AIDS, the Environment and Natural Resource Management. One of the overarching goals of the HEWG is to achieve “… a region of healthy people and healthy ecosystems”. The two concepts are inseparable.

The HEWG has recently launched a Strategic Status Assessment of natural resource management organizations and communities to determine the extent to which HIV and AIDS impacted on their role in managing their natural resources. This study brought to light a number of interesting views from communities and Park agencies alike.

About 73% of community members felt that HIV/AIDS impacted on their community’s ability to manage their environment and natural resources.

The impact of HIV/AIDS on the Managers of Natural resources

For managers of natural resources such as Agricultural extension officers, subsistence farmers, Park Managers and conservancy game guards, HIV/AIDS reduces the capacity of individuals in the workforce. It is pointed out in most National Parks that the tasks required in managing the natural resources are delivered at a slower pace, and more resources are being diverted to health-related expenses.

Conservation staff, in both parks and conservation agencies, have also outlined a number of indicators and effects of the pandemic on the workforce. The common reasons for staff not being able to perform their duties are:

Absence from duty to attend funerals

Lower output levels because of ill health and a general decline in work place productivity

Deaths, absence for personal care or family care

Psychological factors: fear, grief, sense of loss; a crisis outlook where work duties are reduced in priority

This loss in human capability to undertake routine environmental

management tasks such as Fire control, game patrols and game counts and so on, agricultural extension outreach and water point management may lead to a general degradation in the ecosystems that we protect.

The impact of HIV/AIDS on the users of Natural resources; Shortened

Time Horizons.

Rural areas in Namibia rely heavily on natural resources such as firewood, water and land for their subsistence. These non-renewable resources are prone to be exhausted when managed and used in an unsustainable manner. When impacted by HIV/AIDS, users of natural resources are said to shorten their time-horizon, shifting from longer-term sustainable practices to short-term unsustainable practices to meet their urgent, immediate needs.

The HEWG study also highlights general observations from members of communities living adjacent to Namibia’s Parks. About 62.5% of community members feel that unsustainable resource-related activities are on the rise in their communities. The most frequently mentioned activities are:

poaching, unregulated tree felling, over-harvesting of traditional plants from the veld (traditional harvesting methods abandoned) and over fishing.

Together, these compound to result in overall less sustainable

natural resource utilization practices and a reduced ecosystem capacity to support rural livelihoods.

Nine Key findings of the Strategic Assessment

1 Park workers are hit hard by the impacts of HIV/AIDS.

2. The conservancy sector at large is also impacted by the pandemic.

3. Conservancy members – who benefit from tourist income – have relative higher levels of social capital to deal with the pandemic compared to neighboring communities.

4. Women statistically reduce their vulnerability to HIV through participation and employment in the conservation sector.

5. Local pressure to poach is offset by the presence of community game guards. The loss of guards clearly impacts negatively on conservation.

6. Traditional natural resource-based remedies could be diminishing in importance.

7. Vulnerable communities’ livelihoods are dependent on changing and diminishing food and water resources.

8. Information and policy gaps at the operational level lead to varied responses by environmental managers.

9. Discrepancies exist in the veracity of local and national information-sharing networks.

So, how do we protect our environment, wildlife and people ?

The Strategic Status Assessment commissioned by the HEWG has been presented to key partner organizations (government, UN agencies, the Namibian Nature Foundation and the Strengthening Protected Areas in Namibia project etc.) and the impact of HIV-AIDS on institutions such as the Ministry of Environment and Tourism has been noted with alarm. A 5- year Action Plan has been developed to implement a number of activities focused on policy and workplace programme formulation, training and succession planning models.

Already an inventory of the status of HIV/AIDS Policies and workplace programmes has been created and their implementation is set to be monitored.

Succession planning in particular is crucial if institutions are

to retain capacity in terms of people and skills. This may seem inhumane and calculating to some but everybody sooner or later dies and requires a replacement. It is our current tragedy that such thinking is particularly necessary because of the HIV/AIDS pandemic.

Such a model plan, complete with Voluntary Counseling and Testing (VCT); and wellness programmes will be developed and tested to ensure that Natural Resource Management agencies know as much about their labour force as possible.

This programme will enable the institutions to implement ARV programmes that will help prolong staff lives, save lives and be prepared for changes in the labour force. Simultaneously it will help ensure the future of our environment. And the waterholes of Etosha, the other parks, the conservancies will still delight the people of the world and bring invaluable investments to the country and a source of hope to all.

Domestic Violence/Violence Against Women and Children

November 28, 2009

Hi! Hugh here again! Hope all’s well with you.

Lightning is crackling over the Khomas Hochland, the sky, when it isn’t flaring into life, is a sulky grey. Low clouds. Rain tonight I think! And everybody will welcome it (apart from all the English tourists who have just arrived expecting un-remitting sunshine).

Following up on the Claudia/Leonard post of yesterday, I’m placing two posts. They make for rather depressing reading. They are preliminary drafts of two Issue papers I wrote and researched for UNICEF. The information is slightly dated, incomplete and the full versions are probably available (complete with pictures) on UNICEF Namibia’s website (or,if you are here in Namibia, from the UNICEF office which is near the Hidas Centre off Sam Nujoma Drive. )

I don’t want to paint too bleak a picture of Namibia, Annabel our daughter has always been loved by the people here (spoiled rotten actually!)  and none of the stuff you will read affects tourists. It’s more a local thing. But this Blog wants to open closets. And rattle the bones of the skeletons hiding inside.

Then bury them.

So hey ho! Let’s go!



Although Namibia is a signatory to numerous conventions designed to enshrine and enforce the rights of women and children and although some domestically introduced legislation, for example The Combating of Rape Act, 2000, is arguably some of the most progressive in the world, the country nonetheless faces an epidemic of sexual and domestic violence against women and children that has reached crisis proportions.

And there is every indication that unless preventative and mitigating measures are vigorously instituted, and the flaws in the current social and legal systems are eliminated, the problem has the potential to continue its horrific escalation.

As the number of orphans continues to rise (by 2021 it is predicted that over 250,000, or one in three, Namibian children will be orphans) and family social support structures are disrupted by factors such as HIV-AIDS, more and more young people are becoming vulnerable to abuse and are being subjected not just to a violation of their basic human rights but are also being exposed to potentially lethal Sexually Transmitted Diseases (STDs).


Despite popular outrage and demonstrations triggered by several recent high profile child murder and rape/mutilation cases the media continues to report the rapes of adults and minors and instances of domestic violence on a daily basis. And there is no indication that the public attention generated by the murders and trials has in any way stemmed the tide of the ongoing violence.


Compounding the problem is that although the “stranger danger” issue unquestionably exists, the overwhelming majority of victims are being hurt by those known personally to them.  In more than 60% of reported cases, for example, the complainant and the accused were living in the same household at the time the violence occurred. To take another example, in a recent UNICEF-sponsored survey of 1150 women, 74 (6%) of those who have had children reported that their partners had beaten them during their pregnancies.


Nationwide almost one third (31%) of ever-partnered women have experienced physical violence at the hands of their partners. Other studies variously suggest that between 40% and 70% of all female murder victims are killed by their husbands or boyfriends.


Overall, moreover, violence of any sort in Namibia is overwhelmingly sex-biased with between 80% and 90% of incidents being male upon female.


Rape is also rife. And victims as well as perpetrators are increasingly getting younger. The UNICEF study states that a “staggering number of minors” are involved. This is confirmed by officers of the police and police Women and Child Protection Units who report processing juveniles as young as ten for sexual assault on younger children and even toddlers.


The growth in the number of reported rapes does not necessarily indicate that the number of incidents has risen. The statistics may reflect the increased levels of awareness in society that abused citizens have recourse to the law. This said, most experts are convinced trends are up and it is an undeniable fact that the number of reported rapes rose from 564 in 1991 to 854 in 2000 to 1,184 in 2005. For every 100,000 people there are currently 60 rapes per annum, one third of which involve children under eight years.


Various factors have been identified as motives for, or root causes of, abuse, most notably the cultural socializing processes traditionally (and currently) at work in Namibia. These encourage the philosophy of female submissiveness and inferiority and set this stereotype against a preconception of male authority thereby engendering a social power imbalance and instilling a pervasive attitude of domestic ‘ownership’ (see table 2). This can manifest itself in extreme forms such as the custom of “widow cleansing” (involving the male relatives of the deceased having forced sex with the bereaved to ‘drive away evil influences’) and the forced marriage of under-aged girls by their families to old or middle-aged men.


Both practices, while relatively uncommon, still occur, particularly in the north.


Perhaps more disturbingly, however, from a whole-country perspective, is the fact that many men (44% of adult male population according to Government figures) still believe that wife beating is entirely justifiable if the woman a) neglects the children, b) argues with the man of the house, or c) refuses sex. This figure varies considerably when the Government country study is broken into regions. 90.1% of men in Caprivi Region in the north east, for example, consider it appropriate to beat their wives for neglecting children and 69.4% think that if a spouse or partner refuses sex this is justifiable cause for assault. By contrast in Karas Region in the south the respective figures for the above two scenarios are only 8.3% and 3.6% respectively.



Education and cultural socializing processes are not the only forces in play. Frustration born of poverty, the ‘live for the moment ‘ mentality that is generated by a sense of having no worthwhile future, jealousy spurred by multi-partner relationships, lack of access to education/anger management and counseling are all implicated. Whatever the cause, or combination of causes, of the wave of violence washing through Namibia, a predominant trigger is the excessive consumption of drugs but mainly alcohol.



Categories of violence against women and children as identified by Government and other bodies range from the physical (kicking, beating, burning, choking, even be-heading etc.) to the sexual (rape, including marital rape – according to new legislation sexual abuse in marriage is now an offence – child molestation etc.) to the emotional (intimidation, threats, insults, humiliation etc.) and the economic (withholding/stealing household income, failing to pay child maintenance, spending all income on alcohol etc).


As mentioned earlier, Namibia’s post-Independence legislation to address these various forms of abuse is far-sighted and extremely progressive when it comes to embracing issues over-looked by earlier laws. It also empowers courts to sentence criminals to extremely long terms of imprisonment.


There is, however, an increasing awareness among government, NGOs and civic groups that it is not having the desired (and anticipated) effect of deterrence when it comes to crimes such as rape and violence.  As Minister of Safety and Security, Peter Tsheehama stated, “Tough sanctions given to offenders do not offer any remedy. The introduction of the combating of Rape and Domestic Violence Acts, tough as they are, has not brought expected results as perpetrators seem not to take heed of them.”


Indeed one unforeseen and unwelcome side effect to the lengthy sentences threatening convicted rapists as a result of the Rape Act is that sexual offenders are increasingly targeting the frailer members of society – the old, the very young, the physically or mentally disabled etc. in the hope that they will be too intimidated, or indeed, be physically incapable, of testifying at trial (a legal pre-requisite if a case is to proceed). It has been further conjectured that the blinding, mutilation or murder of victims has been stimulated by the fear of imprisonment and the desire to silence witnesses.


It is now generally accepted that the root of the problem lies not in the legislation but in its enforcement and practical implementation. These remain inadequate, tardy and unwieldy.


The length of time it takes to bring perpetrators to justice is an area of particular and fundamental concern. Prosecutions can regularly take as long as three years or more and during this time of waiting many complaints are withdrawn due to peer or family pressure, intimidation by the abuser, acceptance of financial compensation by the victim’s family (but usually not the victim)from the perpetrator, the death of the complainant, loss of evidence or most commonly because of economic reasons – if the bread winner is to be jailed or is waiting for bail to be posted, the families of the abuser are left without income. This can actually lead to the victim of abuse being censured and ostracised for reporting the abuse to the authorities thereby depriving their family or community of financial support.


As a spearhead in the campaign to tackle domestic violence and sexual abuse 15 Women and Child Protection Units (WCPUs) have been established in Namibia’s 13 regions (Photo 2), but again their efforts are being hampered by numerous factors. Their role, while universally recognised as important and badly needed, is undermined by easily rectified failures largely arising from a lack of resources and, in some cases, commitment to the duties they are expected to perform.


Negligence when it comes to providing a victim friendly environment – no privacy during interviews (no private reception facilities), no toys for child rape victims, filthy toilets, interviews conducted through interpreters because the investigative officer is not familiar with local languages, lengthy waiting times before seeing an officer, even a lack of signs advertising the location of the unit – all are common complaints.


More serious and but equally capable of remedy are the reported absence of rape test kits at WCPUs, the absence of spare clothing to replace clothing that needs to be withheld as evidence (some victims are sent back “footing it” to change their clothes and are told to bring back their original clothes from the same house where they were raped), instances of victims being told to come back the next day due to the unavailability of officers (obtaining evidence as soon as possible is essential for rape investigations) and the lack of availability of appropriate transport to investigate alleged rape scenes or to take vulnerable people to places of safety. The Windhoek WCPU, for example has only two vehicles to cover the entire Khomas region (36,805 km2, population in excess of 250,000) and these are largely tied up delivering Protection Orders. In another WCPU there is one vehicle available but three of the officers have no driving licenses and the fourth is not authorized to operate a government vehicle.


Basic office equipment such as computers, photocopiers, fax machines and even telephones at WCPUs are frequently absent, faulty or have gone un-repaired for many months, and in some cases even facilities such as toilets and sinks for washing hands are non existent making medical inspection of rape victims impossible. Only two WCPUs have full-time social workers and even these, like part-time social workers, are only on station during working hours. At night, when most crimes occur, they are off-duty.


No doctors are stationed at WCPUs. The Units instead rely on medical staff ‘borrowed’ as the need arises from nearby hospitals and clinics. This inevitably results in lengthy delays before abuse victims can receive professional examination. Virtually no WCPU’s possess facilities for victims to stay overnight.


While accessing the services of WCPUs is relatively straightforward for urban dwellers, those people living in remote areas with no access to a phone or transport face tremendous hurdles simply reaching them. Unit officers frankly acknowledge that many crimes in rural areas go unreported and that even if the victims wish to make a case there is still some confusion as to where to go and who to see. In many instances poorly educated people are still unaware of what legally constitutes abuse particularly in the fields of emotional and economic abuse.


Pro-active outreach and community awareness programmes that could rectify these latter problems are noteworthy for their absence either due to staff inertia or a lack of resources, materials and Government support.




To address the current shortcomings in the legal procedures and the WCPU network aggressive action needs to be taken on the part of government, police and legal bodies to significantly accelerate and improve the processes of investigation and prosecution, more Public Prosecutors must be retained to ensure prompt trial scheduling, more emphasis must be placed on witness protection, and sufficient resources must be placed at the WCPUs’ disposal to enable them to develop victim friendly infrastructure, install and upgrade basic office facilities and initiate conduct outreach programmes to engage local communities. There is also a desperate need for more social workers at WCPUs – insufficient personnel currently frequently makes follow up service provision or even immediate counseling for victims of abuse impossible – and while there is limited victim counseling training provided to some members of the police at this time, the training needs to be rolled out to all attached serving officers.


Other measures are required; increasing access to relevant education not just on domestic violence but on alcohol abuse, the stationing of psychologists at schools to teach anger management to young people (violence by minors on minors is an increasingly widespread but under-reported phenomenon), the provision of more sheltered housing for abuse victims and multi-media awareness campaigns are all initiatives that are, in some cases, ongoing (eg UNICEF’s Window of Hope programme) but which need to be scaled up.


These steps in themselves, of course, are not a cure-all for the current epidemic of violence against women and children. The factors contributing to such behaviour are diverse, wide ranging, in some cases deeply engrained socio-culturally, and are to be found at individual, family and societal level. This inevitably complicates preventative and rehabilitative measures and makes a multi-dimensional approach essential requiring the participation and co-ordinated  involvement of church groups and networks, civil society, NGOs, Government, and Development Partners.


But there is no doubt that if the investigative and legal process was radically streamlined and accelerated it would not only send an un-missable message to potential abusers but would offer comfort and a relative sense of security to thousands of affected and vulnerable Namibian citizens and society at large.



Some Quotes


The following quotes have been taken from reports, case studies and the media.


“Yes, I abuse sexually,physically, whatever. So what? A female is there for a man’s purpose, and that’s that.”


“I think I have a right as the head of this household to control my family, even use force to control them.”


“In most areas even 13-year-old girls are having sex, therefore, for a boy to get a virgin, the girls need to be ‘taken’ at a very young age.”


“In the Bible a woman is made out of the rib of a man so they need to be inferior.”


“The case of going to small children is not that he wants to go there, but rather it is the case that he cannot control it.”


“The introduction of the Combating of Rape and Domestic Violence Acts, tough as they are, have not brought expected results as perpetrators seem not to take heed of them.”

Minister of Safety and Security, Peter Tsheehama.








Vox Pop: HIV, Health Service, Infant Mortality

November 26, 2009


“You Must Stand Alone.”

Gloria, 23, has fallen through the cracks in Namibia’s healthcare delivery system. HIV-positive she has given birth to, and lost, three baby girls (one within five days of birth, the highest mortality risk period for Namibian new-borns).

As she recounts her experiences, Helen, my Damara interpreter, frequently nods her head in agreement. More than a few times she becomes agitated and answers questions herself.

Perhaps not surprisingly.

Gloria and Helen are saying the same things.

Both women have grown up in poor families in one of the more run-down neighbourhoods in Katutura. Both live in their mothers’ houses (their fathers are dead) and their male partners have abandoned them. They share already cramped sleeping space with members of their extended families and friends of friends. There are sometimes as many as fifteen adults and children staying at Gloria’s two room place. Access to water is a communal stand pipe, some days Gloria doesn’t eat and both households are in arrears on their Municipality electricity bills. A forced auction of the properties has yet to be imposed. But it might be on the horizon.

Maternal healthcare, or rather the lack of it, is another thing they have in common. And this is where both women become angry.

“If you can’t pay, they won’t give you medicine even if you are pregnant and having problems,” Gloria says, adding that even if you do pay the most common prescription is Panado. “You wait and wait for hours at the hospital and if you have stomach sickness they give you a Panado, if you have fever they give you a Panado. What what what! They give you a Panado!”

Anti-retrovirals have never been prescribed to her, says Gloria. And no, she says, she received no drugs to prevent mother to child transmission of HIV. She didn’t even know there were such drugs available. “I don’t feel the hospitals are there for me. I don’t know what is happening and people (medical staff) don’t explain to me or listen.”

The sums of money for some of the prescription medicine Gloria is talking about are small, and to many people might appear insignificant – the equivalent of one or two US dollars in many cases – but for Gloria, who is unemployed and yet is still expected to support her HIV-positive, decrepit,  and alcoholic mother, they are often out of Gloria’s reach.

Subsequent to the interview the interpreter confirms that Gloria, too, has problems with alcohol perhaps due to a turbulent childhood which saw her sent away to several remote farms to live with distant and sometimes abusive or drunkenly negligent relatives. Gloria’s education was disrupted. She is largely illiterate. Although she pretended she could read leaflets that she was given by a mid-wife because she was ashamed she relied on the pictures. And, Helen says, although Gloria is surrounded by people 24 hours a day, this young woman feels lonely and alone. “The people in her house won’t help with money for her. Even when she was pregnant they didn’t care. They didn’t help out with some meat. Not fruit or vegetables. Never money for medicine.”

To its credit, the proportion of the Namibian government’s budget devoted to health care is second only to South Africa in the sub-Saharan region when it comes to size.

Arguably, however, the collection and bureaucratic processing procedures of the small sums paid by patients (pregnant or otherwise) for prescription drugs and treatment cost more money and working hours than they are worth.

Time and again Gloria returns to the theme of money. She says that none of her dead babies even had birth certificates because she couldn’t afford to pay for the documentation process. Bleakly she says that she didn’t even think of a name for her last little girl because she lacked the energy and knew in her heart the infant would die before she needed a name.

She wishes that health care, especially for expecting mothers and new born babies was provided free, but says she doesn’t expect that to happen.

She returns to the topic of waiting times and hospital queues. For a pregnant woman she says these feel twice as long. And the hospital is dirty especially the toilets, she alleges. And everybody is coughing and she says she thinks that just going there is going to make you sick with someone else’s problem.

Gloria then speaks of unpredictability. Sometimes things work well. She gave birth to her second infant in the kitchen space of the house where she was staying. It was a ‘speed delivery, only twenty minutes’ she laughs. And it is good to see a laugh on her young but care-worn face. An ambulance arrived twenty minutes later. Nation-wide, due to vehicle availability and geographic location, ambulance arrivals can take anything between minutes to long hours. Many health centres in remote areas do not even possess an ambulance and it is incumbent on the local community to organize transport of women encountering birthing problems.

After the ambulance dropped her at Katutura Hospital a German “nurse” checked her and made Gloria comfortable. The baby was taken away then died of liver failure and, Gloria claims, nobody told her for three days. She can’t remember even seeing it. “I was waiting and then a nurse said I must go home because I can’t lie there because they need the bed and I said “Where’s my baby?” and the nurse said, “Did you have a baby?” She asked me where it was. They didn’t know.”

She says she also received some advice on what to eat and what not to drink during pregnancy. She admits she ignored most of the advice. She later received injections prior to giving birth (but is not sure what the injections were, she couldn’t understand the nurse’s explanation).

Then she touches on two sinister elements.

One: HIV-AIDS discrimination and the still prevalent attitude that if you have the virus you are already dead and not worth bothering with.

Two: The power and importance of having connections in the healthcare system.

Gloria alleges that, because she is known to be HIV positive, because her first two babies died and because she is not a friend or family member of hospital staff, she was ignored ,at best, during her third pregnancy. At worst she was ignored and ostracized. She claims she was first in line for consultations (these are free) but was usually not called by the receptionist until the waiting room was half empty.  “I am a nobody. I am a ghost to these people.”

“You can lose hope living like that. I wanted to be a mother. I still want to be a mother if what you say is true about medicines to keep the baby safe from that AIDS.  But these people aren’t serious. I won’t go there to the hospitals anymore with any hope. I don’t want Panado. If you cannot pay you must stand alone.”

Gloria doesn’t look as if she can stand much longer.

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