link: http://www.nytimes.com/2011/02/15/health/15global.html?_r=1&ref=health
In a region of the world that is devastated by sexually transmitted diseases, one country is actually in the black when it comes to its success in combatting these dieseases. Zimbabwe, a country in the heart of Southern Africa, has seen its number of individuals infected with HIV decrease sharply in the past decade. In 1997, public health officials estimated that over one fourth of the country's population was HIV-positive. As was seen in last class, and which I so clearly chose to point out, those numbers were most likely a lot higher. However, in a decade, the number of infected individuals fell by 13%, an astounding number even in parts of the world where HIV is not so prevalent. So what exactly played into this amazing decrease? Simple: the citizens of Zimbabwe were, and are currently, having less sex.
Before Zimbabwe's economic collapse in the early part of the last decade, having multiple and frequent sexual partners was a social norm. Now however, men can no longer afford to pay for sex or support multiple girlfriends under the present economic regime. Women are no longer going to bars or beer halls to meet men, and having an STD is now subject to shame rather than pride, as men used to use HIV as a proof of masculinity.
Of course, public health programs are in the mix as well, as AIDS awareness and education has also contributed to the falling numbers. Once again, education has proved itself worthy in the line of duty in the prevention of disease. Zimbabweans who are educated in the consequences of HIV/AIDS are much less likely to have multiple sex partners, and many Zimbabweans now use condoms.
I think this article is perfect for what we are talking about in class. The whole article was based on interviews of 200 Zimbabweans, a job that seems fitting for an epidemiologist. As for the numbers, only a biostatistician could have turned the epidemiologists' data into the decreasing percentage that we see today. I feel like so often, we are exposed to the disparities and ailments that plague our world today. However, in this article I found some bright light. I think it is extremely important to build on the successes of Zimbabwe, and educational tactics that have proved affective should become more widespread.
This article is actually really interesting on a personal level as I have family that live in Zimbabwe. While it's been a long time since I last visited them, I've heard stories about how society and societal perceptions are slowly changing in Zim.
ReplyDeleteI think Zim is a great example of the need to be aware of societal and cultural differences in attempting to treat a disease. This is probably especially true with HIV/AIDS as there are many behavioral changes that can reduce its prevalence, and as a result it's taken a long time for HIV rates to lower. Changing a society's perception plays a large role in this, as mentioned by the changing viewpoints regarding STDs among the general public. I also think that there has actually been a bit of backlash towards the Catholic Church. As a fairly European dominated society, a large portion of the population of Zim is Catholic. But the Vatican's steadfast refusal to support wide distribution of condom's in Africa had previously been a barrier to HIV prevention. But as HIV has become more of a problem, people are starting to turn away from Vatican teachings and instead taking note of public health prevention. This reversal in values represents the standard in public health for adopting strategies to change certain habits within various societies.
I totally agree with what Max said. This issue is one of contradiction between the rights of individuals and their cultural traditions, and the well being of the public. Unfortunately, this conflict often leads to some sticky situations, as well as a need for time-consuming work and creative solutions to overcome it. It's sad to think that it takes such drastic circumstances for people to realize that current traditions are doing more harm than good. The Vatican's refusal had been a barrier to contraceptive distribution, and only when the problem became impossible to ignore were people open to the idea of looking beyond tradition. It may seen frustrating to an outsider because we are tempted to simply say, "just forget about tradition and do what will increase the health of the people." Unfortunately, this can not happen in the field of public health. We can not solve problems around the world unless we think of solutions that are sensitive to the lives and customs of all involved. In order to make effective change, we must gain the respect and participation of those we wish to change.
ReplyDeleteI also found this article very interesting in that it shows the complexity of the different fields of public health and how they are all interconnected. An epidemiologists work would be lost without a statistician. Those statistics would be nothing without a behavioral scientist working to change them and promote healthy lifestyles. The behavioral scientist would not even know where to start if not for the environmental health scientist working to identify the health hazards such as limited access to contraceptives. These are just a few examples, but I find it really interesting to see these different fields each playing a different role in making this improvement possible and giving hope for a better tomorrow.