News No 13 May2000

I would be nice if the HIV virus and deaths from AIDS could be conferenced away. But it just isn't possible.

The human understanding is no dry light, but receives infusion from the will and affections; whence proceed sciences which may be called 'sciences as one would'. For what a man had rather were true he more readily believes.

Therefore he rejects difficult things from impatience of research; sober things, because they narrow hope; the deeper things of nature, from superstition; the light of experience, from arrogance and pride; things not commonly believed, out of defence to the opinion of the vulgar. Numberless in short are the ways, and sometimes imperceptible, in which the affections colour and infect the understanding.

We people of now have no choice but to be fully intelligent - to have the clearest maps of reality in our heads.

Why has Uganda halved its HIV rate? Because in 1987, President Museveni descreed that the challenge facing Uganda was AIDS - and that AIDS in Uganda was caused by sexual intercourse. A programme was started which targeted all the schools. They are said to have emphasised abstinence before marriage. 'We do everything we can think of,' says Museveni, 'when a lion roars in your village you roar back.'

Uganda still has a Christian culture. There were the Uganda Martys: 22 Ugandans, of whom 12 were boy pages , were put to death in 1885 by King Mwanga of Uganda for refusal to renounce Christianity. They were canonised as the first African saints of the RC Church in 1964.

David Hirsch says that AIDS is not a medical problem but a cultural one. Polio is a medical problem, because prevention is possible by medical means. AIDS cannot be prevented or cured by medical means, only by behaviour change.

SAPLER together with many other organisations and with the youth of South Africa is helping to create a new culture. Anyone who has watched 'Take Five' (TV1 at 4.30pm Mondays to Thursdays) or 'S'camto' (e.tv on Thursdays at 6.05pm) will know that this new culture is friendly, open, realistic, and above all simple. No one is using wordy rhetoric or complicated jargon.

The aim is understanding and solving problems. People have to find solutions which fit in with their cultural overviews. Ways of avoiding AIDS do not only include marital fidelity (or the 'one partner' equivalent). Other options are condomisation, non-penetrative sex, having two extremely well-known and trusted partners (immigrants) and complete abstinence. Abstinence is well worth a try with young teenagers who have not started their sex lives.

Abstinence until they are older will give them freedom from cervical cancer, unwanted babies, complicated relationships with boys - happier life, and more time to spend acquiring skills they will need later on. They will also have to understand the complications of sexually transmitted diseases, As this youngest group see older relatives dying, it becomes easier for them to make this choice.

The Hippie generation in the 1960s introduced ‘Make Love not War’ and ‘Anything Goes’. Marital sex was seen as ‘possessive’. If the AIDS virus had been around in those days then half of those mostly white, middle-class, liberal young people, from largely professional homes would have died of AIDS.

I've had sex once.

Will I die?

(seen on a taxi - in very large print)

People ask why Uganda is succeeding in bringing down HIV+ in the young. One reason is that Uganda got there first. Tragedies abound. Those addicted to faulty reasoning on this matter have died. A British woman aged 60, Dervla Murphy, rode a mountain bike from Kenya to Zimbabwe, intending to escape reality. However, in the end she could not avoid the people affected by the AIDS epidemic.

She wrote a book called The Ukimwi Road, published in 1993. ‘Ukimwi’ means AIDS. In Southern Uganda she found a shop run by feminists. One of them, Helen, said: ‘Equality for African women isn’t no more only a nice idea, it’s to save lives. Women with risky husbands have to say ‘'No!’ But they can’t, on their own.

They’re scared, they don’t want divorce. OK, so we get together. A husband living risky comes home and sees not only his scared wife, waiting to obey. He sees a group of women, all with the same problem, all saying the same thing! This is a revolution. It’s bigger than our political revolutions, it’s men made to heat women. Our men have gone weak since all the life changed.

Before they were important, now there's no warriors, no hunters, just lying around drinking. Then hunting girls to prove they're still men! But for us nothing’s changed – work and more work, from before dawn till after dark. Our only change is a bad one - more children, when men only have one wife. You understand all I say? You see how is the revolution - men have gone so weak they're frightened of women in groups!

They can’t say we’re silly, Ankole has funerals every day – and Rakai district is even worse than here. Now for us it’s children first. Mothers want to live for their children. Risky husbands come second.’

In Tanzania Dervla Murphy came across Janet, who ran ‘a safe hotel’, with no prostitutes - no ‘bar-girls’. Janet said her husband disapproved of her ‘purity policy’.

‘He says it’s impossible to run a successful hotel without bar-girls but I say he’s wrong. This hotel is my personal AIDS prevention programme. Men away from home should have such places to stay; now more and more they want to avoid temptation.

If they can have nice surroundings, good food, happy talk in the bar and no women hunting them – then they can safely travel. A year ago I told my husband we must have this sort of hotel, in time it will become popular and already this is coming true, my hotel is getting a reputation for safety. I had to nag and nag at my husband, he didn’t want to know about the figures that put me in this mood... we are the third worst town in the country.

That’s what made me do something, it’s crazy to say nothing can be done! If everyone does nothing, it gets like a sort of mass-suicide. If we don’t change, who will be left in twenty years?’

‘The kindly driver was a Muslim merchant from Dares Salaam, strikingly handsome, with two wives at home and a third beside him in the cab. His ‘travelling wife’, he called her, and she... smiled at him and said, ‘Now only stupid men travel alone, being tempted!’ ... While she travelled, the other wives looked after her 2-year-old.’

Dervla Murphy said that African Christian women made the point over and over again, that men need more than one sexual partner, and that if polygamy was still the custom AIDS would not have spread.

This was done by Dr Martin Terre Blanche, Department of Psychology, Unisa, and Professor Mohamed Seedat, Unisa Centre for Social and Health Sciences. This was a professional evaluation with appropriate checks for validity.

Questionnaires, with places for free comment, were administered to a sample of 671 grade 9 to 12 learners from 10 schools in the Soshanguve-Winterveld area. The questionnaire was designed in consultation with SAPLER staff to measure knowledge, attitudes and behaviours relevant to safe sex. It was piloted with a group of 30 learners and modified where items appeared to be ambiguous or difficult to understand. (‘Pupils’ are now called ‘Learners’.)

Schools were included where SAPLER Pioneers had not yet been, for comparison with the SAPLER schools. This was the conclusion: ‘It was found that learners at SAPLER schools obtained better scores on measures of safe sex knowledge, safe sex attitudes, condom use and low risk behaviour... In addition, it was found that learners from SAPLER schools who had positive safe sex attitudes were also statistically significantly more likely to engage in low risk behaviours. The same was not true for learners from other schools.’

‘Stakeholders had overwhelmingly favourable opinions of SAPLER – both of the basic idea and of the way in which it has been implemented.’ This includes parents, principals, teachers and health care workers.

‘Guidance teachers and principals presented what they perceived to be the impact of the programme very positively. Several referred to pregnancy rates going down (and up again when the pioneer left), while others spoke of a change of atmosphere in their school. One said that the pioneer had ‘transformed the attitude of our students - their personal behaviour is more considerate and they’re more committed. Learners now talk more openly to us teachers as well.’

Open communication has been difficult because of cultural taboos, the generation gap and the effect of television on the youth.

‘The expectation that pioneers would be able to break through the silence appears to have been realised in practice. One guidance teacher said that “I was in a bit of doubt at first. I feared that there was going to be an explosion, particularly since some of the learners are twenty years old - but it all worked out very well.’

‘Once you don’t understand something without hesitation he will explain it with an open heart. He understands the stages of teenagers and why they do wrong things.’

‘I like that she talk openly, without fear and she encourage us to talk about this thing. Because many teenagers do things that they don’t know. They do thing just to please their friends.’

From the evaluation: ‘Although learners’ overall level of safe sex knowledge was high, it was found that a proportion of learners suffer from specific knowledge deficits that should be remedied. These deficits included an incomplete awareness that STDs and HIV/AIDS can be a symptomatic and that “morning after” contraception is possible; as well as uncertainty about the possible side-effects of masturbation and he long-term efficacy of the family planning injection.’

The word ‘masturbation’ has been freely used in the Western press for a long time. Our pioneers and learners are now able to discuss sex freely, so this was a surprising gap.

Only 47per cent of learners at SAPLER schools and 44 per cent at other schools were certain that masturbation (skomola) would not lead to madness. Given this lack of knowledge, it is not surprising that only 42% of learners at SAPLER schools and 39 % of learners at other schools agreed or strongly agreed that it is acceptable for boys to masturbate.

However, once the issue had been brought up in the questionnaire section, some pupils were keen to know more:

‘I just want her to tell us abut why we girls not have to do masturbation. Please correct me if my spelling is wrong.’

SAPLER liaises with everyone else as it arises. One benefit of the AIDS epidemic is that people are more focused on a real issue and less focused on wordy rhetoric and point scoring.

In the evaluation the learners were asked: “Please tell us how you feel about the advice you get about sex and relationships.”

These learners were 17 and 18 years old. Many of them do not live with their parents, but with other members of their family. Some seldom see their biological parents, but there was no correlation at this stage of their lives with how often they saw their parents and how informed they were about sex.

SAPLER learners reported that they got good advice from their families 85 percent of the time, bad advice 0,6 percent of the time and no advice 14 percent of the time.

Scoring highest in this question were radio programmes, which gave good advice: 93 per cent, no advice: 4,5 percent and bad advice: 2 percent.

TV programmes: Good advice: 88 percent, bad advice: 6.5 percent and no advice: 5,5 percent.

Clinics: Good advice: 91percent, bad advice: 0,6 percent, no advice: 8,1 percent.

Church ministers: Good advice: 71 percent, bad advice: 2,5 percent, no advice: 27 percent.

Advice from, boyfriends and girlfriends and other friends was considered less trustworthy, although it was perhaps in fact not as useless as it might have been if the learners had been younger.

Lowest in trustworthy information were traditional healers and initiation schools:

Traditional Healers: Good advice: 29 percent, bad advice: 34,5 percent, no advice: 35,5 percent.

Initiation schools: Good advice: 18 percent, bad advice: 44 percent, no advice: 36,5 percent.

This word means ‘getting a community used to the idea that using condoms is a safe and good way of avoiding sexual disease’.

Using condoms requires diligence, foresight and self-restraint. It would be very much easier to live in a monastery. Living in today’s sexually stimulating world where the HIV virus is living with us and in us requires startling answers.

Parents and priests fear that condomisation will promote the idea of happy-go-lucky sexual attitudes. This is to a certain extent true, if not dealt with in a careful manner.

SAPLER has to get permission from the headmaster or headmistress and the Board to introduce condoms into a school. The Board consists of parents who are usually conservative about this idea.

What our pioneers have done in the idea has been accepted is never just to distribute condoms. ‘A condom distributed is not a condom used.’

On Friday afternoons after school, those learners who wish to use condoms have private sessions with the SAPLER pioneer to make sure that everything is well understood. The pioneers report that those who go this route usually come back the next Friday for the next supply, and this suggests that they are in fact using the condoms.

Condoms are also a good contraceptive, but for some reason this is seldom stated. Young women are told that they must be on the pill or the injection as well as using condoms.

Only people not working with AIDS in a practical everyday way could think that AIDS is not an STD. It is because of the strange nature of AIDS - that it is incurable, that it may not show up for many years after the person is infected, and that it is extremely widespread in South and Southern Africa - that it is spoken of as a separate phenomenon. AIDS can be spread non-sexually – so can the other STDs.

‘STD’ stands for ‘Sexually Transmitted Disease’ and has come to mean all sexually transmitted diseases other than AIDS.

‘If you already have an STD is there more danger of getting HIV/AIDS?’ This would be a puzzling question for people who are not part of this world in which the two terms are used as if they are separate.

I asked older people who are not at risk if they knew the answer to the question. Most guessed correctly. It is worthwhile knowing this if you have children or employ people, as an STD is usually curable - and because it is an excellent opportunity to discuss the issue. Good communicators can often talk teenagers out of unsafe sex if they use the window of opportunity offered by an STD.

The answer is ‘Yes.’ 75 percent of SAPLER learners knew this for certain. Another 17 percent were unsure.

Another question, one which my own friends had much more difficulty answering was:

‘Can you have an STD for years and show no symptoms?' A lot of people of the older generation believe that AIDS is different in this respect and that other STDs show up very soon after the infection is transmitted. But the answer is that one can have symptom less STDs and also STDs which don’t manifest themselves for years.

Nevertheless of the killing diseases, AIDS is the one which is characterised by a lack of symptoms within weeks, months or years.

To the question, ‘Can HIV/AIDS be cured?’ 67 percent of SAPLER learners said ‘No’ but an unacceptably high number - 16 percent said ‘Yes’.

We are not reaching everyone, but this evaluation will enable us to find out why, and we will also be giving regular tests on basic information.

Approximately 25 percent of pregnant women in the North West Province are now HIV positive. The knowledge of the teenagers does not correlate well with this figure. But knowledge takes time to translate into behaviour change, and sexual desire and male persuasion can cancel all knowledge when the heat is on.

In America a research project was done on male college students. The students were answering questions anonymously in the quiet mood of a college morning. A very high percentage of these students admitted that they had lied about their ‘safe-sex status’ at the moment when they wanted unprotected sex with their girlfriends. In other words they conveniently ‘forgot’ in the excitement of the arousal that they had, say, three years ago, had unprotected sex with another girlfriend.

Edward Mabunda told me last night of an astonishing sermon he attended in Winterveldt. He himself is not religious, but he had heard that the sermon was to be on AIDS.

The priest said, ‘I am prepared to marry any couple in my church, providing they both have the AIDS test first.’

I can’t imagine any sentence changing behaviour faster than this one. Imagine falling in love, deciding to get married and have children, and then being faced with the fact that one or both of you might have AIDS.

Lettie Dube was our first female pioneer. She and Edward Mabunda run our project. Lettie is 23 years old and was educated in a single-sex school in Zimbabwe. She and Edward have put forward the idea of twinning the schools in North-West, so that all the boys and the male teachers go to one school, and all the girls and the female teachers go to the other.

David has taken this suggestion to the policy-makers, but so far has had no response to it. Many of the present pressures in the schools would fall away if this was implemented.

In the 1950s it was considered enlightened and progressive for schools to be ‘mixed’- ‘so that boys and girls can get to know each other in a natural setting’.

My niece, Alice, who went to Woodmead High School in the 1970s and who was pestered for sex throughout her high school years, said afterwards that she wished she had gone to a single-sex school.

Lettie Dube runs a radio programme on Saturday mornings from 9 to 12. It is called The Comfort Zone, and provides reassurance and comfort for anyone who is suffering. From 11 to 12 listeners can phone in.

We will eventually lose Lettie. At present she still lives with her mother, but in time she wants: ‘A house, a husband, and a baby - in that order.’ She is thinking of doing a part-time course in journalism.

We have employed jobless young people in an age of joblessness. We train them and they gain experience. They can gradually train themselves for more remunerative work, and will find it more easily because of what they have done with SAPLER.

One of the answers to the unemployment problem is to allow young people to work for less than the legal wage. They can stay at home, postpone parenthood and lead rewarding lives.

SAPLER aims to expands its programme. David Hirsch has been liaising with Dr. Karodia, DDG of the Department of Education, North West Province. In his proposal to the province David writes: ‘Family planning includes safe sex practice, the promotion of voluntary HIV counselling and testing, responsible teenage sexuality and the widespread training and employment of youth and rural women in community service.

The AIDS pandemic, the unemployment crisis, the current destitution of 8-9 million Africans, the abuse of women and children, and environmental resource limits all have a strong need for family planning in common (and indeed are different facets of a single national crisis). SAPLER made substantial input to the White Paper on Population Policy in 1997 and most recently on the Draft Policy on HIV/AIDS and STDs in Schools.’

To expand we need administrative, managerial, financial help, and help with co-ordinating training programmes and evaluation programmes. For this purpose we are being helped by NICDAM, which is the National Institute for Community Development and Management.

NICDAM helps with capacity building and social reconstruction. Some of their programmes include:

This newsletter was written by: Ann Cluver Weinberg and published by SAPLER

Phone David Hirsch (011) 477-6447, e-mail: info@population.org.za

website: www.population.org.za

P.O. Box 51446, Raedene, 2124

Newsletter No: 13	13 May 2000
If what you wish was true	Culture
Risky Husbands come second	The safe hotel
Only stupid men travel alone	The Sapler Evaluation
They like us	Masturbation - our weakness
Whose advice can you trust?	'Condomisation'
STDs and AIDS	Have the AIDS Test
Lettie Dube	Nicdam

SAPLER Population Trust
Splendidly Alive People Within Limited Environmental Resources