Contextualising the journey
CHAPTER 1 The Journey begins
2.4 HIV and AIDS in Lesotho
This study focuses on the experiences of women teachers teaching sexuality education in rural Lesotho schools in the age of HIV and AIDS. In order to understand their experiences, we firstly have to understand the context of Lesotho in relation to the pandemic.
2.4.1 Lesotho‟s policy initiatives on HIV/AIDS
According to UNAIDS (2008) Lesotho is among the highly affected countries in terms of HIV infection rates with a 23.2% nationwide prevalence. HIV and AIDS threaten the development and survival of the Basotho nation. Thus in 2000 HIV and AIDS were declared a national disaster by His Majesty King Letsie III. This has lead to the development of the first National Policy Framework (GoL, 2000). To signal its commitment to the fight against HIV, Lesotho signed several declarations responding to the pandemic. Lesotho has prioritised MDG 6 which is about eradicating HIV and TB to
become number one because it is a national priority. These initiatives show Lesotho‟s commitment to curb further spread of HIV and AIDS among its citizens.
A revised National HIV and AIDS Policy came into effect in 2006 (National AIDS Commission (NAC), 2006). The revised policy framework is aimed at addressing the multi-sectoral implementation of national responses by providing appropriate coordination of interventions. Highlighted in the framework is the challenge of addressing the possible infection avenues. The framework also emphasises the government‟s commitment to ensuring universal access to prevention and empowering people who are vulnerable in order to ensure resilience.
As discussed in the previous section, Lesotho has also implemented curriculum policies that aim at information dissemination among school-going Basotho youth (Motalingoane- Khau, 2007b; Mturi & Hennink, 2005) in order to reach them with information that can save their lives. With the implementation of the Free Primary Education (FPE) Lesotho hoped to provide access to formal education for all Basotho children (Mokobocho- Mohlakoana, 2005) such that they could be in a better position to get equipped with the necessary sexuality, HIV and AIDS knowledge and survival skills.
Despite the implementation of FPE, some Basotho children do not attend school at all and hence the government has also developed curriculum policies for non-formal education through different stake-holders including the Ministry of Health and Social Welfare and the Ministry of Education (BoS, 2001). Sexuality, HIV and AIDS programs run through these two ministries, by nurses and volunteers from home-based care support groups, are mostly aimed at reaching shepherds and children in the remotest parts of Lesotho where access to primary health facilities and formal education is still problematic.
The implementation of policies is, however, dependent on the buy-in of the communities for which the policies are designed, and thus it is important to understand how HIV and
AIDS are perceived in Lesotho. The following section looks into the perceptions of different community members on HIV and AIDS.
2.4.2 Perceptions on HIV and AIDS
HIV infections and AIDS related illnesses and deaths in Lesotho are negatively skewed against girls and women (Motalingoane-Khau, 2006; 2007b). Long (2009b) argues that girls and young women are more vulnerable to HIV infection due to biological and socio- economic factors. Within the hetero-patriarchal context of Lesotho, women and girls find themselves vulnerable to HIV infections due the societal constructions of masculinity and femininity which favour male sexual prowess and female sexual passivity (cf.
Mokobocho-Mohlakoana, 2005; Motalingoane-Khau, 2006, 2007b; Mosetse, 2005).
Patriarchy in this study in understood to mean a system of practices and social structures through which men dominate, exploit and oppress women (see Khabo, 1995). The patriarchal gender order in Lesotho is problematic as it favours the performance of hegemonic masculinity and emphasized femininity (Connell, 2000). Men who perform the hegemonic masculinity tend to be violent, sexual predators, risk takers, and adventurers. These performances of hegemonic masculinity place men at risk of infection.
Ranotsi and Worku (2006) also point out that Lesotho has an urban prevalence rate of above 28.9% among adults. They argue that the threat of HIV and AIDS to rural Lesotho populations is exacerbated by the return of retrenched rural Basotho men from South African mines (cf. Campbell, 1997, 1999, 2001). According to Campbell (1997), the socio-economic context of migrant workers increases their vulnerability to HIV. She argues that the living conditions of mineworkers, who are mostly men living far away from their families and social support systems, creates a fertile ground for HIV infections. Family Health International‟s (2002) study also showed that mineworkers and taxi drivers had very low knowledge in relation to HIV and AIDS. Their study also showed that among all age groups condom use is very low, with a tendency for multiple concurrent partners (Family Health International, 2002, pp. 6- 14). Studies conducted by the Lesotho Planned Parenthood association (LPPA) (2002) and Family Health
International (2005) show that Basotho children engage early in sexual activity before gaining any knowledge on issues of sexuality, hence the spread of HIV is alarmingly high among them. These studies argue for the youth to be educated about their sexuality and how to prevent new HIV infections.
While I have discussed the merits of a virginal bride in the previous chapter, this does not mean Basotho youth are not engaging in premarital sex. Mturi, Tuane and Diamond (1997) and Makatjane (2002) state the sexual debut of many Basotho children being as early as 9years old. More often than not, such experiences are of unprotected sex. This has also been recorded for other African countries by Meekers (1994) who did a comparative study on premarital sexual experiences for women in seven sub-Saharan African countries. Early sexual debut shows that there is need for age-appropriate sexuality education programs that address children of all ages. While it may be difficult for parents and other adult stakeholders in education to accept that children need to be taught about safer sexual practices, this discomfort is better than having to face children who are already infected with HIV because they did not have the necessary knowledge and skills to protect themselves and their partners.
Another important factor in Basotho people‟s perceptions in relation to HIV and AIDS is the belief in witchcraft (cf. Walker, Reid & Cornell, 2004). People infected with HIV are supposedly bewitched or cursed by God and malevolent Balimo (ancestors). Such people, supposedly, need to make sacrifices to appease Balimo before healing can take place.
Walker et al., (2004) argue that it is difficult for families that believe in witchcraft to seek medical help for their patients. They would rather consult traditional healers who are expected to counter the evil that is causing destruction in their family. This seriously limits efforts to remove the stigma attached to the disease and to encourage families and communities to accept their HIV-infected members. Because of stigma, many people die AIDS-related deaths but the cause of death is never revealed, leading to Basotho people arguing that they have never heard of anyone dying of AIDS. Additionally, the stigma associated with witchcraft leads to the silencing of people regarding their HIV status, thus leading to chances of them infecting relatives and partners who take care of them (cf.
Susser, 2009). In this context it is of utmost importance for children to be educated about sex, HIV and AIDS such that they can take care of themselves properly while taking care of sick parents and relatives. Sexuality education that can reach such children with the necessary information can save their lives and prevent unnecessary infections.
Another dimension to Basotho people‟s perceptions is given by Akeke, Mokgatle and Oguntibeju (2007) who write that religion has a significant bearing on people‟s knowledge, attitudes and beliefs in relation to the transmission of HIV in both positive and negative ways. They have observed that Catholic Christians frown at the use of condoms while all other denominations and religions in Quthing do not support pre- marital sex, sexual promiscuity or homosexuality. These authors argue that while knowledge about HIV was high among the inmates they interviewed, misconceptions and unfavourable attitudes to people living with AIDS are still high (Akeke, Mokgatle &
Oguntibeju, 2007). The studies discussed in this section show that even though Basotho people have some knowledge about HIV and AIDS there exists several ways of understanding the disease which create challenges for de-stigmatisation to occur. Thus the stigmatisation and subsequent marginalisation of people affected or infected with HIV is a big driver of transmission among Basotho.