| "Fighting
AIDS is a Fight against Poverty"
By Chris Simpson DAKAR - After 13 years as a front-line fighter against AIDS in Africa, Charlotte Ndiaye has no illusions about the scale of the task ahead. "We have to admit that so far we have failed," says the new President of the Society of Women and AIDS in Africa (SWAA). "We have to sit round a table, take another hard look at the problems we are up against and think again". Ndiaye says she knows all the old messages and has no time for the ones which failed. "It's no longer useful to talk about 'fidelity' and 'abstinence'. These are strategies which have been tried and didn't work because they simply weren't realistic," she argues. "We have to define a new approach," she continues. " That means not only campaigning for better access to medication and backing the search for a vaccine, but putting Africa's AIDS problem in the African context. "Fighting AIDS is about fighting poverty too." Ndiaye's recent trips to Rwanda and South Africa provided her with brutal evidence of the work still to be done. "We are still faced with a calamity, a tragedy, and it's not going to go away." While Ndiaye's own medical background is in dentistry, with a PhD in oral pathology, she was quickly drawn into the campaign against AIDS, becoming Secretary-General of SWAA in Senegal in 1988. AIDS had already begun to have a serious impact in West Africa. The first case had been recorded in Senegal in 1986 and subsequent research focused on the spread of 'HIV-2'. Ndiaye says SWAA's work was made easier by the government's willingness to tackle the issues head-on and by the pragmatism of religious leaders who brought AIDS out of the shadows. "A lot of public health resources were devoted to AIDS. Senegal was not like other countries where attempts were made to hide the problems". Ndiaye points out that prostitution is legal in Senegal, enabling an easier monitoring of sex workers and a less intimidatory approach. Organisations like Awa, meaning ÔEve', have brought sex workers into their activities, encouraging them to talk to their peers, building up support networks. "There is a lot of respect for women in Senegal", Ndiaye points out. "The lessons we learned here can be exported, but the changes we want can take a very long time. In countries like Rwanda, they have their own, unique difficulties to deal with. In war zones, the problems are much more complicated". Nevertheless, with 34 branches in different African countries, Ndiaye says SWAA has become an important forum. "We now have women coming together from all over Africa and that is something which has inspired me. The exchange of ideas is always there." SWAA has always placed its emphasis on community health, trying to get in at the grassroots. The new SWAA President says it is the only way to make any headway. "You need to have umbrella groups which can function properly. The so-called ÔBig Projects' just don't work if you don't know how to talk to people. "What we want to avoid is experts arriving, delivering their information and leaving," Ndiaye continues. "You have to talk and discuss. It's not good enough to come in and set up a programme that will run for one or two years and then will collapse when the money runs out. You have got to build up a local network which can be counted on". She talks about a highly successful drive on the distribution of female condoms in Tambacounda in the remote far east of Senegal. "We gave out 10,000. It was a great success and then the money ran out. You have to remember that these things cost two dollars each and that puts them out of people's reach." When Senegal hosted a SWAA conference in 1998, the theme was: "Expanding the Response: Enhancing the Participation of Men". But Ndiaye says men are still out in the cold when it comes to understanding the issues. "However intelligent a woman, however capable, it is never easy to negotiate your right to safe sex. You can have a woman who completely understands why she should be using a condom but then has no control over the decision". SWAA has worked for the inclusion of men, but with little success, Ndiaye concedes. "We have asked men to come in and talk, but when we hold workshops, they don't come. Then they get hurt and say they weren't invited. That has to change. We have to reach out to the fishermen, the farmers, the truck-drivers." Prevention must remain the priority, says Ndiaye. She supports campaigns for better access to drugs for HIV-infected patients, particularly for mothers after child-birth, but warns that better medication is not a panacea. "We have had cases where a child is given a drug, but that child can't eat properly, breathe properly or sleep properly, so there is no benefit, and that is down to poverty". Ndiaye also adds debt relief to her manifesto on AIDS, saying it's up to political leaders in Africa to push the case. The SWAA President does see clear signs of solidarity and goodwill from would-be partners in the North, but Ndiaye says the global AIDS campaign must become more decentralised, more hands-on, more in touch with the people it is trying to help. "We don't need to have major international conferences year in, year out, it's a waste of resources. Sometimes I'm left with the impression that some people in the North are actually making a living thanks to AIDS, while in the South, people are dying from it". |
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