US embassy cable - 01GABORONE3514

UNCLAS SECTION 01 OF 02 GABORONE 003514 
 
E.O. 12958: N/A 
TAGS: KHIV, EAID, SOCI, MASS, PHUM, BBG, BC 
SUBJECT: A GRASS-ROOTS LOOK AT HIV/AIDS IN BOTSWANA 
 
REF: GABORONE 3255 
 
INTRODUCTION 
------------ 
 
1.  DURING OUR RECENT TRAVELS UPCOUNTRY, THE AMBASSADOR 
AND EMBASSY STAFF LOOKED AT COMMUNITY-BASED ACTIVITIES IN 
THE FIGHT AGAINST HIV/AIDS AND INTERAGENCY USG SUPPORT 
FOR THOSE EFFORTS.  IT WAS A SOBERING EXPERIENCE THAT 
EMPHASIZED THE DEBILITATING SOCIAL EFFECTS OF THE 
DISEASE. 
 
SELEBI-PHIKWE: "NUMBER ONE IN THE COUNTRY, NUMBER ONE IN 
THE WORLD"; THE STIGMA OF HIV IS "GENOCIDE" 
------------------------------------------- 
 
2.  ON OCTOBER 19, WE ATTENDED THE OFFICIAL OPENING IN 
SELEBI-PHIKWE OF ANOTHER TEBELOPELE VOLUNTARY COUNSELING 
AND TESTING CENTER.  AS PART OF OUR INTERAGENCY EFFORT, 
THE IBB/VOA STATION MANAGER INITIATED NEGOTIATIONS WITH 
LOCAL AUTHORITIES FOR THE PLOT OF LAND, THE OFFICE OF 
DEFENSE COOPERATION BUILT THE STRUCTURE, AND THE CENTERS 
FOR DISEASE CONTROL AND PREVENTION PROVIDED EQUIPMENT AND 
STAFF.  THE OFFICIAL OPENING, WHICH ATTRACTED AROUND 200 
PEOPLE, WAS AN UPBEAT EVENT WITH A SERIOUS THEME.  IT 
INCLUDED A TENT AND LARGE "KNOW YOUR STATUS" SIGNS TO 
ATTRACT ATTENTION ON THE TOWN'S MAIN STREET; A SKIT IN 
SETSWANA ON HIV/AIDS; AND SPEECHES BY LOCAL OFFICIALS, 
THE AMBASSADOR AND THE MINISTER OF HEALTH. 
 
3.  IN AN IMPASSIONED SPEECH ALTERNATING BETWEEN ENGLISH 
AND SETSWANA, MINISTER OF HEALTH JOY PHUMAPHI USED A 
PHRASE WE HAD NOT PREVIOUSLY HEARD FROM GOB LEADERS.  SHE 
SAID THE STIGMA ASSOCIATED WITH HIV/AIDS IS THE WORST 
CRIME THAT BATSWANA HAVE EVER COMMITTED AGAINST 
THEMSELVES AND SHE TERMED IT "GENOCIDE."  SHE ALSO 
STRESSED THE POINT THAT A LEGAL DOCUMENT OF MARRIAGE DOES 
NOT PROVIDE ANY PROTECTION AGAINST HIV AND URGED PEOPLE 
TO BE TESTED PRIOR TO MARRIAGE.  (SHE HAS TOLD US IN THE 
PAST THAT IN BOTSWANA, WHEN ONE PERSON IS INFECTED, THE 
SPOUSE IS GENERALLY ALSO INFECTED.) 
 
4.  IN HIS CLOSING REMARKS, THE TOWN CLERK DERISIVELY 
PROCLAIMED SELEBI-PHIKWE AS "NUMBER ONE IN THE COUNTRY, 
NUMBER ONE IN THE WORLD" IN HIV INFECTION.  HE NOTED THAT 
BOTSWANA LEADS THE WORLD IN HIV INFECTION RATES AND 
WITHIN THE COUNTRY SELEBI-PHIKWE HAD TAKEN THE TOP SPOT 
FROM FRANCISTOWN.  HE CITED THE MOST RECENT ESTIMATES 
FROM THE DECEMBER 2000 HIV SURVEY FOR BOTSWANA (FUNDED IN 
PART BY CDC) ESTIMATING THAT 45.7 PERCENT OF ADULTS AGED 
15-49 IN THE TOWN ARE HIV POSITIVE.  (SEE REFTEL FOR A 
FULLER SUMMARY OF THAT SURVEY.)  THE CLERK ALSO DESCRIBED 
THE HUMAN IMPACT OF THE TOLL: THE COUNCIL CARES FOR 445 
ORPHANED CHILDREN WHO ARE SCATTERED IN FOSTER HOMES 
AROUND TOWN (POPULATION 50,000). 
 
FRANCISTOWN: HELPING CHILD-HEADED HOUSEHOLDS WHERE 
PARENTS HAVE DIED OF AIDS; OTHER VULNERABLE CHILDREN 
--------------------------------------------- ------- 
 
5.  IN FRANCISTOWN THAT EVENING, MINISTER PHUMAPHI (WHOSE 
PARLIAMENTARY DISTRICT IS FRANCISTOWN EAST AND WHOSE 
HUSBAND IS A PROMINENT ATTORNEY) HOSTED THE LAUNCHING OF 
A TRUST AIMED AT ASSISTING (THROUGH PROVISION OF SHELTER, 
TRAINING, ETC.) THE LIVES OF DISADVANTAGED MEMBERS OF THE 
COMMUNITY (INCLUDING THE NEEDY, HOMELESS AND DESTITUTE 
ORPHANS).  THE BASIC HOUSE TO BE PROVIDED TO THOSE IN 
NEED WILL CONSIST OF ONE BEDROOM, ONE KITCHENETTE AND ONE 
BATHROOM BUILT ON A SLAB FOR A TWO-ROOM HOUSE.  MANY OF 
THE COMMUNITY LEADERS OF FRANCISTOWN (POPULATION 84,000) 
WERE IN ATTENDANCE AND THE MINISTER OF LOCAL GOVERNMENT 
GAVE THE KEYNOTE SPEECH. 
 
6.  PHUMAPHI TOLD THE AMBASSADOR THAT MUCH OF THE WORK OF 
THE TRUST WILL BE AIMED AT CHILD-HEADED HOUSEHOLDS, WHERE 
CHILDREN AS YOUNG AS 14 ARE CARING FOR THEIR YOUNGER 
SIBLINGS AFTER THE DEATH OR INCAPACITATION OF THEIR 
PARENTS DUE TO AIDS.  OTHER HOUSEHOLDS TO BE ASSISTED 
INCLUDE THOSE IN WHICH BOTH PARENTS HAVE DIED AND THE 
AGING GRANDPARENTS ARE HAVING DIFFICULTIES COPING WITH 
CHILD-CARING RESPONSIBILITIES.  ACCORDING TO PHUMAPHI, 
THE PERFORMANCE OF CHILDREN AT SCHOOL TENDS TO DECLINE IN 
THE LAST YEARS PRIOR TO THE DEATH OF A PARENT AS THE 
CHILD SUFFERS FROM STRESS AND ADDITIONAL DUTIES AT HOME. 
THE AMBASSADOR EXPRESSED SUPPORT FOR HER EFFORTS AND 
PROVIDED AN APPLICATION FORM FOR SELF-HELP PROGRAM 
FUNDING. 
 
7.  ON OCTOBER 20, THE SHINING STARS OF FRANCISTOWN'S 
MONARCH COMMUNITY OFFICIALLY OPENED THEIR NEW FACILITIES 
PAID FOR BY ODC AND THE SELF-HELP PROGRAM.  MINISTER 
PHUMAPHI AND THE AMBASSADOR WERE KEYNOTE SPEAKERS. 
SHINING STARS IS A COMMUNITY OUTREACH PROGRAM, ORGANIZED 
UNDER TRUSTEESHIP OF THE TSHIRELETSO AIDS AWARENESS 
GROUP, BENEFITING 275 VULNERABLE CHILDREN AGED 2 - 18. 
THESE INCLUDE THOSE WHO ARE DESTITUTE, HAVE ILL PARENTS, 
OR ARE ILL THEMSELVES.  THE ORGANIZATION DOES NOT LIMIT 
ITSELF TO "AIDS ORPHANS," AS AIDS CARRIES A STIGMA THAT 
IS AUTOMATICALLY TRANSFERRED FROM PARENT TO CHILD. 
CHILDREN ENGAGE IN LIFE SKILLS, ACADEMIC AND SPORTS 
ACTIVITIES AND ARE EDUCATED ABOUT HIV ("SO THEY CAN STAY 
BEHIND WHEN EVERYBODY ELSE HAS GONE," ACCORDING TO THE 
SHINING STARS DIRECTOR).  ALL WORK IS PERFORMED BY 
VOLUNTEERS, AS THERE ARE NO PAID STAFF.  ONE OF THE TASKS 
FOR ADULT SPONSORS IS TO CARE FOR PARENTS SICK WITH AIDS 
SO THAT THEIR CHILDREN CAN ATTEND SCHOOL. 
 
8.  THE ODC SUPPORT, PROVIDED THROUGH DOD'S HUMANITARIAN 
ASSISTANCE PROGRAM, INCLUDES TWO BUILDINGS, A 
CLASSROOM/LIBRARY AND A KITCHEN/COMMON ROOM/REST ROOM 
FACILITY.  THE AMBASSADOR'S SELF-HELP FUND HAS PROVIDED 
SHINING STARS WITH EDUCATIONAL EQUIPMENT, FURNITURE AND A 
COMMERCIAL OVEN FOR PRODUCING BREAD FOR SALE TO THE 
COMMUNITY.  PROCEEDS FROM THE SALE OF BREAD WILL BE USED 
TO COVER ORPHAN-CARE OPERATING EXPENSES.  IT IS HOPED 
THAT THIS WILL REDUCE SHINING STARS' DEPENDENCE ON LOCAL 
DONORS AS WELL AS GIVE ORPHAN BENEFICIARIES A SENSE OF 
BEING ABLE TO CONTRIBUTE BACK TO THE COMMUNITY. 
 
9.  THE DIRECTOR HAS WORKED VERY HARD AND IS DOING A 
COMMENDABLE JOB, BUT SHE STILL DOES NOT RECEIVE ENOUGH 
COMMUNITY SUPPORT FOR EVERYDAY EXPENSES: THE ELECTRIC 
COMPANY HAD THREATENED TO CUT OFF POWER ON THE DAY 
PRECEDING THE EVENT.  THIS IS THE SAME ORGANIZATION WHERE 
THE CHILDREN, DURING OUR VISIT LAST YEAR, SERENADED US 
WITH A SONG CARRYING THE HAUNTING REFRAIN, "MY MOTHER 
DIED BEFORE I MET HER." 
 
COMMENT 
------- 
 
10.  THE TWO-DAY TRIP PROVIDED US WITH ANOTHER GLIMPSE AT 
THE PERVASIVE IMPACT HIV/AIDS IS HAVING ON BOTSWANA.  NOT 
ONLY ARE MANY ADULTS ALREADY INFECTED, INCLUDING NEARLY 
ONE OUT OF TWO PEOPLE IN THEIR 20S, BUT LARGE NUMBERS OF 
CHILDREN ARE SUFFERING EITHER BECAUSE THEY WERE BORN HIV 
POSITIVE OR BECAUSE THEIR RELATIVES ARE DYING OF AIDS. 
AMONG THE MANY USG PROGRAMS IN BOTSWANA RELATED TO 
HIV/AIDS, WE WILL CONTINUE TO SUPPORT PROGRAMS AIMED AT 
ASSISTING SUCH NEEDY CASES. 
 
 
LANGE