To e-Forum 2008

The GF mechanism could include behaviour modification component in community system strengthening for specific gender(men)rather than more accessibility & divergence of ART for men,the behaviour modification component should be based on voluntary testing, effective way to avoid contraction & spreading diseases, cultural& social factors for ethical bio-behaviour approaches, universal precautions.

For gender fact component in CSS , healthy conditions for maternal healthcare,nutritional concepts,well equipped primary center& availability of all ART drugs,should be included in GF mechanism. Regarding addressing robust data for the need of global equity strategy I would like to give reference of effective interventions.
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Received discussion on gender issue.Regarding robust addressing data for the needs of women, girls,& sexual minorties understanding of social,cultural,traditional& economical interventions are essential. Robust data can include human ecology,bio-behaviour,& reciprocity of social,economic,physical,biological environmental factors. For reduction of HIV/AIDS vulnerability to women,girls& sexual minorties robust data should be based on multiple factors i.e. social& structure factors including demographic,religion,& educational(literacy level of female),raising awareness about HIV/AIDS before marriage ,partners,use of preventive methods, economical factors including micro-insurance,income,family& social support ,housing & employment.

Data related to population &individual's opportunity for access of general health protection,understanding of pathogens, conducive education policy for universal primary education with health education model based on human ecology,bio-behaviour change process and its integration with physical& social environmental factors rather than primary sexual education can give sound approach & potential impact on reduction of vulnerability of HIV/AIDS & reduction in high risk of sexual behaviour.

ASHISH SRIVASTAVA
EX-International marketing
& c.c.m (SEAR-INDIA)
81237 

Hi, Fenna, Thank you for your comments on my earlier post . It is good to know that you will be addressing the Dakar Conference on Higher Education and will be presenting a research paper. Looking at the excerpts you have shared with us via your e-mails, I am sure your contribution will be highly appreciated from an expert who understands the core of the issues concerning this complex problem. Knowing a little of the cultural scene in sub-Saharan Africa, the introduction of the virus was a tragedy waiting to happen anytime on a massive scale. And it has. You probably are right about the statistics, but I don't know who has the most reliable and trusted data. Until we do, we have to rely on the usual sources. May I add that official estimates are also inflated for various reasons. All I am saying is that any strategy revision should be based on evidence. There are numerous advantages of doing so. Most of all that is an efficient way of formulating strategies. It allows to include all classes of relevant groups that include men, women, service providers, policy makers, students, teachers, and so on. It also enables programmers to be dynamic in their approach and focus on those needing most attention. You have very ably pointed out, women suffer more not out of ignorance alone but also because of their traditional and cultural position in society. Unless women are empowered through knowledge and economic means, their status will not improve. Awareness is also a potent tool that needs to be provided to all regardless. Who knows that there are some men who really care for their women and do not want to harm them. Moreover, men need to know that by adopting safe sex practices, the life they may save may be their own. Lastly, I hope you can give one message to the Dakar group on my behalf. "Please don't be prescriptive in your advice to men and women. Describe to them, in a language they understand, how and why these diseases spread, what damage they cause, and how can they protect themselves. The choice is theirs. In other words, just admonishing them to use condoms or be faithful, etc. is prescriptive, and therefore, a faulty advice." Regards. Javed Ahmad

Ravichandran and Asish, Thank you so much for your very positive contributions. It is very important to consider that women are more diagnosed as being HIV positive compared to men because they are first one and sometimes the only one to be tested, and they are also the ones to see the doctor first because of their pregnancy. This has absolutely no bearing on me trying to stereotype women or men and neither am I trying to say that women need preferential treatment over men, or that this justifies a gender strategy. The latter is a total seperate issue. I am a speaker at the Third International Conference on Quality Assurance in Higher Education in Africa. (ICQAHEA). Dakar, Senegal, September 15-17, 2008 in Senegal. We will be addressing the MDGs in Higher Education. It the third time I'm inserting an excerpt of my paper. "Furthermore, until the gender and cultural perspectives of HIV/AIDS are tackled we can forget the fake figures because millions of lives are at stake. What we must consider is the relationship between the current infections and functional literacy rates. This is further complicated by the gender and cultural perspectives of the disease which not only deserve serious attention, but it must be tackled to understand the HIV disease and halt the transmission and address the gender and cultural issues associated with this." I see there are many of you opposed to a Gender Strategy because you don't fully understand the implicatons of not having a Gender Strategy. I have no intent to debate you or fight you. I have no time for this. I am advised by one of the most highly respected Gender Experts in the world that has operated on all UN levels and also on regional and international bodies. She was a former Minister of Gender and Social Development, Honorable Mrs. Zoe Bakoko Bakoru. She is world renown for her position on such issues. She is my chief advisor for 5 years on Gender, HIV/AIDS, Women Empowerment and Socio-economic development in Africa. She shaped policy on the international, global, regional and country level and has been a formidable voice up 2007 when she went into exile. I applaud SADC on their accomplishment and will personally push for the same in the East African Community and IGAD region. Regardless of the outcome of the debate, whether or not the Gender Strategy should be developed for the GF, I will move forward with the initiatives of our organization. Be assured that at the country and regional level my voice as a scholar is respected and I will support all their initiatives. None of us has the power to reverse the Gender Policy 14 countries have adapted and adopted in SDAC and more countries will follow. This is just the beginning of things to come. I will strongly support the fight on the country and regional level and know that there is no way anyone can reverse the gains that have already been made. done. We need a Gender Strategy to conquer this monstrous HIV disease because most deaths that occur in Africa for example are among women. From a cultural and historic perspective, men are too proud to come forward to seek treatment because they will be ostracized and alienated in their place of work or anywhere else no matter how educated they are. Once infected the stigma is ever present and takes on a life of its own, snowballing into something much bigger. In a certain country among a certain ethnic group highly educated Masters and Ph.D male relatives of these infected siblings/inlaws are so stigmatized even though they have not been infected at all, that unintentionally they become an obstacle to other relatives from being tested and seeking treatment. This is what you all don't know what is happening in the villages among certain African cultures. Men feel so stigmatized and ashamed to get treatment or to take time off from work to be tested and seek treatment because of the fear of losing their job and being ostracized. The problem is ofcourse on the level of many employers who need to be enlightened; however, the finanancial burden on an employer is hard to bear no matter what. So many men with HIV in the work place in Africa stay untreated even though they suspect what is going on especially if their girl friends become "sick", they simply leave them and move on to a new wife. Suddenly, you find out that the string of wives all are infected and the man dies while a one or two of the girlfriends outlive him by a few months. The culture also stands in the way of men seeking treatment because many times they feel the women have bewitched them to become ill so they go to the witchdoctor. Then suddendly you hear that XXXXXX became gravely ill was admitted in XXXXXX hospital for 1 month and he died of HIV. This male was actually very aware of the cause of his first wife's death of HIV, but lived in denial. He always told me he is feeling so good and looked very healthy (he was also educated in with a 2 certificate from the hospitality industry). He never had a sick day from work in 5 years. He suddenly became ill was tested and had one month later he died leaving his wife with 5 young kids. He likely infected the new wife (his first wife died of HIV) and the new wife doesnt know what he died off... This is the story of millions of households in Africa where either the man conceals from his wife and tells her to get tested to be sure... Men should be at the forefront of this battle, but there are socio-cultural factors that prevent millions of men across communities in Africa to come forward. This also has to do with their own pride. However, not all men are like that. There are many men that are proactive and we need to applaud them and encourage to form peer counseling groups in their communities to overcome this terrible stigma. It will take a transformation of worldview among men to change this stigmatization and lion pride they experience. This should be encouraged in all community health programs. Now back to the women. Because women are usually unaccompanied by their husband they get tested for a successful pregnancy outcome...to prevent the complications of all types of birth anomalies, birth defects, premature birth, still birth, preeclampsia, eclamsia, sexually transmitted diseases (STDs) that can be transmitted to the foetus etc. We need to continue encouraging our rural women despite their limited literacy (many fall within the illiteracy spectrum) to seek preventative prenatal care so we can make a drastic dent in the Infant and Neonatal Mortality Rate and also most critical the Maternal Mortality Rate. These complications already burden the inadequate Health Care Infrastructure of developing nation. So that is where she finds out for the first time she is infected with HIV. Now how can she go home and tell her husband? What will he suspect? The first thing he will tell her that she is unfaithful and abuse her very badly. This is one reason we need a Gender Strategy because if we deal with patriarchal societies where women have no rights or say. Not until we address gender and cultural issues associated with HIV we will never halt the transmission of HIV and stop it in its tracks. Let us keep our head level with regards to this debate because don't matter what the outcome is our goal should be to achieve dignity for both men and women. However, it is the women that bear the worst brunt of this disease, the women that suffer most, and the women that die most of this disease. Thank you for allowing to make this contribution and that we don't jeaperdize the lives of people. It is most interesting and contradictory when people North of the Saharan desert, where HIV infections are not prominent and not a problem compared to the rest of Africa, are against a Gender Strategy in this e-forum. Prevelence of HIV infections are worst South of the Saharan desert. It reflects their limited and narrow understanding of cultures and gender issues South of the Saharan desert. We cannot ignore such at all because this will negatively influence Gender Policy in Africa. What is happening in Asia in terms of Gender may differ from what is happening South of the Sahara. Let us be sensative about this. I will not stop calling for a Critical Gender Strategy and shift in paradigm regardless of the opposition. The many noises of the frogs will not stop the lion from drinking water. Drs Bacchus