HIV/AIDS: Zambia’s silent emergency
No apparent signs of devastation, conflict or extreme famine in Zambia. People move through Lusaka much like any other capital city on the African continent. Markets are hectic with business, taxis rumble through frenzied streets, and it often seems as though only the rainy season might dispel the city from its busy routine. Nonetheless, Zambia is caught in the grip of a very real HIV/AIDS emergency which has left government reeling and distressed, the international community deeply concerned, and Zambians perishing from the virus – 96,000 people in 2006 alone according to a projection from the Central Statistical Office.
Indeed, the HIV/AIDS situation had become so dire that, in September 2004, an official state of emergency was announced in order to cope with the rapidly growing demand for antiretrovirals. The disease has created a crisis of such immensity that it is crippling all realms of society, from government and industry, to civil society and the family. With HIV prevalence ratios as high as 1 in 6 Zambian being infected, virtually no individual escapes the implications of the pandemic.
A Ministry of Health employee for over 24 years, Elizabeth Phiri has spent the last 22 as a registered nurse and midwife at Chelston Health Clinic in the Chelston district of Lusaka, witnessing her share of community distress. Despite the realities of her work, Sister Phiri, as she is known, maintains a glowing smile, sharp humour, and keen sense of perspective. Armed with these charms she remains positive about the difficult working conditions in the Zambian emergency.
As Sister Phiri points out with biting wit, not so long ago things were much worse. In the early nineties, the pandemic was barely noticeable in the neonatal section of the clinic, but only a few years later the situation had escalated dramatically and, in 2003, 8 out of 10 pregnant mothers visiting the clinic were infected with HIV. Worse yet, barely 20 per cent of visitors would even agree to be tested. To put the statistics into perspective, it is estimated that at least 40,000 children in Zambia are born with HIV yearly, with a third of these children not surviving long enough to see their first birthday, and half perishing before their second.
However, over the past years, Chelston Health Clinic has instituted numerous creative methods to assist in combating the pandemic. Some of the more atypical strategies have included peer-to-peer consultation with an HIV-infected counsellor and drama groups, which offer objective glimpses into the social realities of the disease, thus exposing social stigma. Sister Phiri views these efforts as making real impact and estimates that the HIV prevalence rate of women visiting the clinic has fallen to 6 out of 10. More importantly, people are becoming comfortable with the idea of being tested. Not solely pregnant women, but their partners are joining in as well. And it is testing that is a significant tactic in turning back the resilient nature of the disease.
Why is testing such a vital tool for stopping the spread of HIV in children? “When an expectant mother is known to have HIV and the appropriate precautions are taken, the mother-to-child transmission rate sits at less than 5 per cent. However, without these precautions transmission rate is estimated at 30 to 40 per cent,” Sister Phiri notes.
Sister Phiri is not alone in her assessment. With over 13 years of experience, the Head of UNICEF Zambia Health Section Dr. Tesfaye Shiferaw agrees that programmes focusing on the prevention of mother-to-child transmission (PMTCT) of HIV, like the one implemented in Chelston Health Clinic, are having significant impact. “Without PMTCT programmes many newborns would have little chance of long-term survival,” he notes. “PMTCT strategies are one of our best weapons for combating the spread of the AIDS pandemic.” And it is clear that, whether speaking on the ground with Sister Phiri, or at the international level with Dr. Shiferaw, Zambia must persevere in its attempts to curtail the emergency. With an estimated 1 million orphans, Zambia could be moving towards a social disaster. This is, in fact, a silent emergency, but one which penetrates all corners of Zambian life and slowly devastates its population with catastrophic consequences.
© UNICEF Zambia/2006