The countries of southern Africa today have the highest rates of HIV/AIDS in the world. The United Nations figures for June 2000 show a seropositive rate among adults of 19.54 percent in Namibia, 19.94 percent in South Africa, and a staggering 35.8 percent in Botswana. The epidemic threatens to undo the development gains of recent decades and cause incalculable hardship and suffering among the ordinary peoples of the region. In certain districts in Botswana, life expectancy has already fallen from 55 to 37. In parts of KwaZulu-Natal, half of all adults are carrying the virus.
The San people are located in the heart of the world region hardest hit by AIDS. How has the AIDS epidemic affected them? Very few studies of HIV have focused on the San, but some work has been done among the Ju|’hoansi people straddling the border between Namibia and Botswana. The picture is preliminary, but already shows both hopeful and ominous signs.
As late as 1987 there were no cases of AIDS reported from Dobe or Nyae Nyae, and the peoples of the region wondered if the disease would somehow bypass them. By the mid 1990s, however, cases began to appear, and both areas now have many cases. Although reliable figures are lacking, between 50 and 100 HIV-positive Ju|’hoansi--in a population of about 2,500—might be living on both sides of the border. This figure may seem high, but it is not. Compared to levels in cities, towns, and along truck routes elsewhere in Namibia and Botswana, the incidence of the disease--between three and six percent as compared with national averages of 20 to 35 percent--is quite low among the Ju|’hoansi.
Condoms Are Key
Since 1996, we have been studying social and cultural aspects of the AIDS epidemic in Namibia and Botswana. In the course of this work, we have traveled widely and interviewed men and women in urban and rural settings. (Susser, 2000; Lee, 2001) In Africa, AIDS is primarily a heterosexual disease, transmitted mainly through unprotected vaginal intercourse. The most effective means of preventing transmission is condom use. For a variety of cultural and economic reasons, abstinence and/or strict monogamy do not appear to be viable solutions. Recognizing the realities of the situation, governments and international agencies have made condoms widely available without charge through clinics and health posts. At Tsumkwe, Namibia, for example, the international organization Health Unlimited and the government clinic both distribute condoms.
Despite the known dangers, many Namibian men object to the use of condoms. Men view the condom as implying unfaithfulness and become angry if the issue is raised. Their reaction has placed Namibian women in a very difficult situation. Ovambo and Damara women say that if a husband or boyfriend does not want to use a condom, there is little they can do about it for fear of being abused or abandoned.
But a striking contrast emerged in our interviews in how young Ju|hoansi women negotiate sex compared with women of other Namibian ethnic groups. Ju|’hoan women told us that the decision to have sex with a man is their own and not forced. One said she would not agree to sleep with a man unless he used a condom. Other girls expressed caution about entering into any kind of liaison. And the maintenance of strong kinship ties among the Ju|’hoansi has meant that women are not forced by economic necessity into the transactional—sex for food—arrangements common elsewhere in the region.
Ju|’hoan women’s long noted sense of empowerment and high status relative to men has proven to be a valuable defense in the fight against AIDS and contributes to the lower HIV-positive rates among the Ju|’hoansi. The high status of Ju women noted in the more “traditional” past (Draper, 1975) has proven crucial to their avoidance, so far, of the most devastating effects of the AIDS crisis.1
Unfortunately, not all Ju women are as thoughtful and prudent as our informants. In parts of both Namibia and Botswana, young Ju women participate in the drinking culture of shebeens and home-brew establishments, which cater to men from outside the communities. These liaisons have created points of entry for HIV infection, and the virus may spread from these AIDS “hot spots” to the wider community.
The Kalahari Peoples Fund (KPF) currently produces AIDS education kits appropriate to Ju|’hoan language and cultural values. The KPF is convinced that AIDS education must be part of all future development work and included in every project from well-digging to natural resource management. The Workgroup for Indigenous Minorities in Southern Africa (WIMSA) has endorsed KPF’s initiative and is extending it to other indigenous groups. The next decade will determine whether the Ju and other San communities are able to develop the coping skills necessary to survive in the age of AIDS.
More information will be posted on www.kalaharipeoples.org. See also page 58.
Endnotes
1. A new national men’s organization, called Namibian Men for Change, has also emerged. It is committed to combating violence against women. Unprotected sex in the age of AIDS can be considered an act of violence.
