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Lecture 6

Week 6 Lecture Note

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Session 5 Why Botswanians die young HIV/AIDS & Changing age structures
HIV/AIDS prevalence rates
Table shows ten countries with highest prevalence rates and ten countries with
lowest rates
If these prevalence rates are high, then these countries have a problem
If you compare the absolute numbers, then the US is much lower than Kenya
HIV/AIDS is a worldwide problem, 95% of cases are located in Africa
Why is this the case and what has been done about it?
Spread of HIV over time in sub-Saharan Africa, 1982-1997
Only in the year 2005, 1 million people died of AIDS-related causes in sub-Saharan
HIV/AIDS in Botswana
Botswana is among the ones with the highest prevalence rates
34% prevalence rate in 2006
45% prevalence rate among pregnant women age 25-34
Life expectancy
o1991: 70 years
o2005: 36 years
Although in 1990s, there were lots of AIDS cases spread over African countries, and
still, the numbers are rising until now
One of the reasons is political reason in these countries no one talked about
HIV/AIDS, even political leaders didnt talk about it, and thats why its called the
silent tragedy
oOnly in 1999, South African president still questioned that HIV was a cause
of AIDS, this is why lots of people in South Africa didnt trust the AIDS
campaign that was set out in South Africa
oHIV was discovered in 1970s when there were more cases discovered in the
oThe disease was formerly known and researchers discovered AIDS in 1983,
then they were able to trace it back in time to 1950s not only in US but to
central and East Africa
oIt began spreading there as a disease to monkeys, and then it crossed the
species barriers from monkeys to humans, in a way it was tragic as well
oVirus was spread because it was from monkey kidneys
oAfrica had quite a lot of time to develop more cases because it was spread out
from there, and this was discovered in 1970s in US and took a long time to
realize that the origin was from Africa and then started programs to treat
these diseases
The second cause this started in Sub-Saharan Africa was there was a silence about
these diseases related to sexual practices
oBecause the local knowledge systems in these countries worked differently
than western countries
oQuite a lot of diseases were thought that the origin was spiritual defects that
go with punishing people when they are socially behaved in the wrong way, so
this is why quite a lot of people think this is nothing related to biological
oAlso talking about sexual practices was a taboo in quite a lot of population
groups in Sub-Saharan Africa, only recently this taboo is lifted and talked
openly about sexual practices in these countries
Third, there is a stigmatization going on with people who had the AIDS disease, this
segregated people from these communities
oThe AIDS campaigns as a third cause for spread were out there from 1990s,
however, these campaigns were not appropriate for knowledge systems, were
designed in the logic like people think in these companies and not translated
to local knowledge systems in Sub-Saharan Africa, and they were in English
(most people didnt speak English)
oThese are reasons why HIV/AIDS was perceived as a problem for
Whites/Europeans as they dont have to deal with it
Fourth reason was economic and social modernization process going on since
independence, going on in quite a lot of countries
oEconomic growth and urbanization processes shook up the whole system of
how the society functioned in these countries
oThere happened a dissolution of social networks for the dissolution of
extended families where quite a lot of people moved into the cities, and this
helped spread HIV/AIDS
Fifth reason: food and income security played a role in here
oWas maintained in lots of those countries by using migration within the
countries between different sites, so they moved from workplace to workplace
or moved their cattle to another country
oLifestyles spread HIV as well
One more reason is the dissolution of social networks that affected women so when
women ended up in cities, they were poor and ended up in slums
oTo cope with daily struggles of life, quite a lot of them had to prostitute
themselves or were forced into sexual violence
Last but not least, sanitation, hygiene problems, and not very good nutrition helped
spread the disease as well
Gapminder World
Income per capita on x-axis, and life expectancy on y-axis
In the first couple of years of independence, they discovered diamonds in Botswana,
and this helped to develop the country and to increase life expectancy quite rapidly
However, there was a turning point around the 1990s as well in Botswana as in
South Africa, and this was a point when HIV hit Botswana
You can see how huge the impact can be traced in demographic terms
Botswana is most tragic case as well as the most hopeful case because they started
fighting against it by having anti-AIDS program
To treat HIV/AIDS: if you want to stabilize a patient with AIDs, it is very expensive
per patient
This is why governments need help and sponsors to fund this
It is estimated that economic growth is dampened by 2-3 percent each year, that
means AIDS is quite a huge impact in a country
The social consequences are: stigmatization
In Botswana, almost everyone is infected and knows someone who is infected
It affects households when breadwinner dies, it affects the wife or husband
It affects women and children in sub-Saharan Africa when women die, children
become orphans on the street if their grandparents dont want them
That means others will be infected with AIDS eventually
The only way out is the justice to knowledge system
Testing is costly but gives people to check whether or not they are infected, and if
they are, can be told how they can avoid infecting others
Private health care can help these countries