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Showing posts with label africa. Show all posts
Showing posts with label africa. Show all posts

27 June 2010

Bringing African Perspectives into US Activism (#USSFafrica)

Thursday and Friday I attended many of the Africa focused workshops - most were very exciting and engaging. They really brought the African perspective into the ideas of the US Social Forum and made delegates think about the US role in issues affecting communities on the African continent.

24 Thursday 10am-12pm

African Unity Towards What? (Pan-Africanism & Nationalism is not enough!) by: University of Kmt
I still haven't exactly figured out this group and what they do. They run the Kmt Press which publishes books and journals, but all of their sessions that I attended were focused on teaching with an African historical perspective. Their missions states that they are dedicated to educating the new generation of African leaders. Interesting that they are in Detroit and I wonder if they know of the Detroit Public School (DPS) Initiative starting in 1992 where Africa was integrated into school curriculums from math to literature.
24 Thursday 1-3pm

Prioritizing Africa & the African Diaspora Agenda from Detroit to Dakar (D2D) by: Priority Africa Network (PAN)
This People's Movement Assembly was geared towards bringing African perspectives into the US Social Forum and continue the discussion as preparations are made for the 2011 World Social Forum in Dakar, Senegal. The room was full of delegates from many African countries, Detroit, and US Africa Advocacy groups.

Briggs Bomba, Director of Campaigns at Africa Action, spoke strongly about building solidarity with those most affected in Africa. He said, "corporate led globalization has harshest effects on those in the perifery, the underdeveloped." He reminded us that all of us the privilege to attend conferences like these and make the policies need to prioritize the communities most affected.

A delegate from South Africa spoke eloquently about the social apartheid of displacement - ideologically, locations, in decision-making and governments; in voting process lack of people power and transformational action, and in the social mainstream. "We cover many issues, but it is the same struggle. We come from different areas, but share common experiences." (i.e. colonialism)

Some top issues that came out of the PMA:
  • Militarization in the Congo (DRC)
  • HIV & STDs from Detroit to Africa
  • political economy - effects seen in everyday Africa
  • African defense (defend communities), liberation (not yet liberated), and autonomy
An exciting and dynamic session that really makes me excited for the World Social Forum in Dakar!
24 Thursday 3:30-5:30pm

The New Africa Command & U.S. Military Involvement in Africa by: African Security Research Project (aka: Daniel Volman)
This session was an interesting overview of AFRICOM by some leading scholars on the topic of US national security interests in Africa. The attendees were less diverse than the Detroit to Dakar session and most people came to learn more because it looked interesting and had studied Africa to some small degree in the past.

Most interesting was when the discussion turned to private military contractors (PMCs) in Africa responsible for fighting wars in Libera, Southern Sudan, and Somalia. A Ugandan delegate actually talked about being trained by PMCs in Iraq to then return and fight the Lord's Resistance Army in Northern Uganda. Great to hear the perspective of the Ugandan delegate and Dan Volman as well as to see so many people interested in learning more about African issues!
25 Friday 1-3pm

Power-sharing Deals in Africa: Implications for Democracy - The Case of Zimbabwe & Kenya by: Africa Action
This was by far the most organized session that I attended at the US Social Forum. The Africa Action team did an amazing job of gathering great speakers, formatting the session, and bringing people into the room for the discussion. Many African voices were heard from delegates representing Zimbabwe and Kenya.

In both cases of power-sharing, the speakers agreed that the power-sharing deal was a sigh of relief that stopped the fighting and opened their doors to the international community and economy again. However, they also all recognized that power-sharing was a positive in the short-term, but can be positive as in the case of South Africa when Mandela and de Klerk signed a power sharing deal until the national democratic elections.

Here are some take-aways:
  • A weak state can and will be manipulated (i.e. Museveni in Uganda - waiting for a similar situation as Kenya and Zimbabwe soon, elections next year)
  • "The people" are separated from the power - people-centered in needed
  • Power-sharing allows for lessened tensions and time to create national unity towards something better
  • Coalition governments show defeat of "people power"
Crossposted from SCOUT BANANA

23 June 2010

The Africa Track at the US Social Forum (#USSFafrica)

There are a number Africa-related organizations represented at the US Social Forum focused on bringing Africa into the larger US social justice context and ensuring that there are African voices represented.

During the June 22-25 conference there will be 14 workshops presented by: Africa Action, TransAfrica, HealthGAP, Support Darfur Project, All African Peoples Revolutionary Party, University of Kmt, Priority Africa Network, Community Alliance for Global Justice, African Security Research Project, Athletes United for Peace, Detroit to Dakar, and International Development Exchange (IDEX). See list below:

24 Thursday (10am-12pm)
  • Africa & Pan- Africanism in this hemisphere: fighting neo-colonialism, racism, class, and gender oppression
    • All African Peoples Revolutionary Party @ Cobo Hall - Rm. W2-61
  • Building a Pan-African Solidarity Movement in North America
    • Support Darfur Project @ WC3 - Rm. 317
  • AIDS isn't over: Solidarity in the fight for justice for people with AIDS worldwide
    • HealthGAP @ WA - Rm. 1472
  • Gender Militarism and US Corporate Violence in Oil Producing States
    • Priority Africa Network (PAN) @ Cobo Hall - Rm. O2-40
24 Thursday (1-3pm)
  • Africa Unity Toward What? (Pan-Africanism & Nationalism are not enough!)
    • University of Kmt @ Cobo Hall - Rm. O2-38
  • The Politics of Exploiting Need: AGRA (Alliance for a Green Revolution in Africa), the Gates Foundation, & the Food Crisis
    • Community Alliance for Global Justice @ UAW - Rm. Taurus
  • Migration & Militarization of U.S. and European Borders: A Comparison & Contrast
    • Priority Africa Network @ Cobo Hall- Rm. O2-40
  • Youth-led Activism in NYC's Public High Schools
    • Support Darfur Project @ WBC - Rm. WB2
  • The World Cup, Sports & Social Justice: The Beautiful Game & Beautiful Struggle, Together
    • Athletes for Peace @ WSU S - Rm. 29
24 Thursday (3:30-5:30pm)
  • International Financial Institutions & Climate Change: Community Impacts in the Congo
    • Africa Action @ WC3 - Rm. 337
  • The New Africa Command & U.S. Military Involvement in Africa
    • African Security Research Project @ UAW - Rm. Pres
25 Friday (1-5pm)
  • Prioritizing Africa & the African Diaspora Agenda from Detroit to Dakar (D2D)
    • Priority Africa Network @ Cobo Hall - Rm. W2-69
  • Educating African People: K12 through Ph.D. levels
    • University of Kmt @ Cobo Hall - Rm. O2-38
  • GM Crops - the poisoned chalice: perspectives & victories from South Africa
    • International Development Exchange (IDEX) @ Cobo Hall - Rm. D3-23
  • Power Sharing Deals in Africa: Implications for Democracy - The Case of Zimbabwe & Kenya
    • Africa Action @ WSU S - Rm. 261
Crossposted from SCOUT BANANA.

10 January 2010

transitions in a land of confusion

I have to say that starting this blog and maintaining it has catalogued some of the better experiences in my short life as well as opened many new and exciting opportunities. And so it is with great pleasure that I am making an effort to renew my writing passion and zeal to write down my experiences and thoughts, perhaps someday to write a book? who knows. . . Is this a new year's resolution of sorts, maybe, but I am not resolving to do anything. Writing is a creative and organic process, so I won't place any restrictions or expectations, just to start writing again when the mood hits me. I used to use writing as a release: from stress, from the insanity of the real world, from my mind's own prison. . .

My writing really took a downward spiral in and after my three-month internship in South Africa. Access to the internet was limited, I continued to journal almost daily, but maintaining this blog was just not possible with the work I was doing. It was a long and difficult summer full of rewarding, but intense experiences. Returning to the states, getting back into the blog only became a burden as I worked to adjust and get back into the swing of life in the US as my last year of college loomed.

That year finally happened with attempts to get back into writing, most were short lived. As I feared the most, I was one class short of graduating! I walked for the ceremony, but thankfully could utilize the summer months to complete an independent study and officially receive a degree. Bachelors of Arts (international relations & global area studies: Africa with a specialization in international development) in hand really started focusing, harder than before, on finding a paying gig in the real world. My plan was to find something that (#1) paid, (#2) was in Michigan, and (#3) didn't make me compromise my morals. My goals were to give back to the great state of Michigan, remain in close proximity to the staff of my fledgling organization, and spend more time with the people I love.

It all happened to work out when I was hired at buildOn, a non-profit organization with the primary goal of building schools in other countries to fight illiteracy and bring education to children all over the world. The organization does this through after school programs at high schools in Michigan's urban hubs (Detroit, Dearborn, Pontiac) where students voluntarily learn about global issues, give back to their own communities through service, and raise money to sponsor schools in Nicaragua, Mali, and Malawi. Since August 5th 2009, I've been working this great opportunity straight out of undergraduate studies that allows me to follow all the criteria I had set for myself.

I now live in Detroit (more to come on that later), own a car, get a big boy salary with benefits, and am still running my own non-profit in my free time, SCOUT BANANA. On top of all of these life developments I will be starting a Masters in Social Justice program this month at Marygrove College in Detroit, two minutes down the road from the house I now live in. They have an incredible history of acting outside the norm, radically focusing on helping people, and pursuing scholarly activism that promotes social justice. I am excited to get started in their 7th Cohort of students!

It has been a time of many transitions. Some easy, some not so easy, but all have been successful with a good dose of confusion, flexibility, and an amazing girlfriend who has made everything much easier! Be on the lookout for some more blog posts to close out my South African experience in the Summer of 2008, some of my non-expert opinions on Detroit, and some more generally interesting thoughts on the coming year. Everyone has predictions, so why not throw some more out there? I will also be headed to remote Nicaragua in early February with a group of buildOn students to build a school, so there is definitely some great experiences to come!

09 October 2009

the coming revolution in african health care

african power fist Pictures, Images and Photos

Before you have anything else, you have your health. Hopefully if you have nothing else, at least you have your health. Unfortunately, for millions across the African continent this is not an absolute fact. Even more unfortunate is the fact that many Africans have no ability to change their health status. They are trapped in a system that is driven by Western market based, profit driven health care systems. As the failures of Western development practices come to light, alternatives to what has been are becoming increasingly visible. These alternatives will form a revolution in African health care delivery. This revolution will be fueled by health care delivery models that will give local communities agency in the provision of their own health care. Community-based models involving cooperative financing, proven para-professional training, new information technology, and social enterprise for the social good will drive the revolution in African health care. People will be able to determine for themselves, their level of health.

What does “Health” mean anyway?
This is a question often left to remain ambiguous. For the purposes of my writing I will provide a comprehensive view of “health” and all that is entailed in sustaining and maintaining health. “Health” in all instances will refer directly to the “basic needs” of a person in regards to health care.
Healing, like health, is obviously rooted in the social and cultural order. [...] To define dangerous behavior, and to define evil, is to define some causes of illness. As the definition of evil changes, so does the interpretation of illness. To understand change in healing, we must understand what it is that leads people to alter the definition of dangerous social behavior. It can easily be accepted that health and healing in Africa are shaped by broad social forces.
As Feierman and Janzen state, health (and healing for that matter) are directly linked to social forces. If a comprehensive understanding of health is to be understood, it must be studied in the context of politics, economics, and other societal structures.

Health is defined by the World Health Organization (WHO) as, “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The WHO and many other international organizations recognize that this broad and encompassing definition of health. Where this definition becomes ambiguous is what qualifiers meet, “a state of complete physical, mental, and social well-being.” In 1978 the WHO made primary health care its number one objective with the Declaration of Alma Ata. However, even this statement had no clear definition of health or its qualifiers.

Feierman and Janzen provide a more clear definition of the qualifiers of health in the preface to their volume: The Social Basis of Health and Healing in Africa,
[…] it [health] is maintained by a cushion of adequate nutrition, social support, water supply, housing, sanitation, and continued collective defense against contagious and degenerative disease. Such a view is necessary if we are to understand those contexts in today's Africa where health levels deteriorate, and where they improve.
These authors provide a complete set of qualifiers, or “basic needs,” of health that can be researched further to understand where political, economic, and social structures interfere with sustaining and maintaining health and where health care is inadequate.

Health care should thus be understood as the system and structure that works to provide the above defined “basic needs” to each individual. Often this role falls to governments, but sometimes is taken up by communities and organizations when government’s fail to provide these basic needs.

This blog series will cover four key areas identified that will fuel this revolution in African health care: cooperative financing, para-professional training, information technology, and social enterprise. SCOUT BANANA works to tackle social medicine (social, economic, structures) while enabling others to provide medical services. Be sure to follow closely to learn more!

Written for the SCOUT BANANA blog. 

09 September 2009

global health is everyone's responsibility

ban
People young and old across the US have connected with seven different communities across the African continent to support locally initiated health projects. Using the vibrant color of bananas and the enthusiasm of youth, a new nonprofit has grown to support the coming revolution in African health care.

It all began with one individual, Fr. Joseph Birungi, who had the dream of providing access to basic health care in a remote area where he worked. His dream was transferred on to me through his stories of those who died because they did not have access to basic health care. At the time I was a 14 year-old who knew little of the world beyond Michigan's borders, but I was inspired to do something. Just entering high school, I was full of naive optimism with a goal to figure out how I could make an impact in the world. Although I was youthful, naive, and optimistic I had an incredible mentor, my mother. She helped me form basic assumptions that laid the foundation for my understanding of "global health as everyone's responsibility. "

One assumption that grew from my optimism was the belief that everyone had the potential to make a difference in the world. From Fr. Joseph to myself to my mother, the chain of individuals who embodied this grew to include hundreds of families, church congregations, school assemblies, and individuals from across the country working to fund an ambulance. These individuals, linked by a common cause, were able to raise over $67,000 in less than three months for the health center in Uganda.
It is easy for many people to take for granted the small things: clean water from a sink, medicine readily available in your cabinet, adequate food sources, etc. In the summer of 2002, I was able to traveled to Uganda. During my one-month stay I met and lived with the people who would benefit from the ambulance project. The people I met were so friendly and, even in their poverty, they wanted to share what little they had. I have seen that all people of the world share the same needs and wants. Everyone needs food, shelter, clean water, and necessary health care. We all want to know happiness, health and love. Parents everywhere want the best for their children and children want to learn and grow. But not everyone gets the same chance for success. And so keeping in mind the interdependent and similar nature of our world it is not so difficult to see "global health as everyone’s responsibility."

As I graduated from high school with my classmates so did SCOUT BANANA. My friends began expanding our work into Chapters at colleges and universities across the US and Canada. This allowed our outreach to grow along with our ability to support more local projects. We became seriously focused on community-based solutions and empowering young people in the US to take responsible action when "making a difference" in Africa. Just because you have the means to do something doesn't necessarily mean that you should. With an expanding support base and the desire to empower young people and community leaders we decided to pursue 501c3 status in order to better serve as a resource. Utilizing privilege in the US to connect communities in Africa with inspired students, SCOUT BANANA has been able to raise almost $200,000 to date and engage over 50,000 young people in partnering with African projects to provide access to basic health care.


SCOUT BANANA believes that global health is everyone's responsibility and that everyone has the potential to make a difference. We look at global health issues systematically and our solutions are focused on revolutionizing structures as well as shifting paradigms of development thinking in regards to education, power, and privilege. We seek to create lasting social change in African health care and believe that solutions come directly from communities in need. SCOUT BANANA is dedicated to empowering community solutions as well as young people who want to responsibly make a difference in Africa. By connecting communities in long-term cooperative partnerships, we will build a movement dedicated to fundamental social change in which global health is everyone’s responsibility and every individual’s human right.

SCOUT BANANA is a nonprofit organization that works to provide access to basic health care in Africa. Focusing on community-based solutions and empowering community leaders as well as young people who want to make a difference in Africa, SCOUT BANANA is supporting the innovation in African health care. The organization connects student Chapters with local health project in Africa.

Learn more about the Chapter network & apply to launch a Chapter at your school HERE!

Written for Change.org's Global Health Blog.

31 August 2009

vvocf education fund


17 June 2008
Sphe and Nhlanhla helped me learn some more Zulu today with even more Swahili similarities coming to light. The Bantu peoples spread from central to east and south Africa, thankfully they kept the same language structure and vocabulary similarities.

Today we began the VVOCF Education Fund! We had the idea of collecting the 5 cent pieces that everyone throws on the ground to be collected and used as a way to provide educational scholarships for the VVOCF students. The four teams will have a competition with the winner getting some prize determined later - the students in secondary will be able to apply for the scholarship later. This will be a way for the children to invest in their own education while providing ground to approach other investors overseas or in more wealthy neighborhoods/ SA businesses. Funding cannot solely come from the outside so this is a great start. "Our future is in our hands" education campaign begins today!

The on-the-ground of running a project and NPO is exciting and a great experience for me to see to be able to find out how SCOUT BANANA can be most helpful to our own projects later. Linking education with health development will be important. Giving youth a voice in-country is just as important as giving developed youth a voice to help other youth.

18 July 2009

a day wasted on the youth

15 June 2008
There is a sort of perpetual dance party on the weekends. Many people remain drunk off of the South African Breweries – remnant of apartheid appeasement of township and settlement peoples – and they blast their old tunes and techno beats to the high heavens and well into the late hours of the night. Is this their escape? Is this the real South Africa? Where the people are, is the real South Africa – not Sandton, Florida, or Alberton – but the townships, the majorities, the people that make South Africa; in their miseries, poverty, diseases, lack of family, absence of hope and utter lose for future dreams attained – the real South Africa resides with these people who have yet to realize and actualize their potential with support from uncorrupt (transparent) organizations that can give them and their children the resources to overcome, but never forget.

16 June 2008
The day rings hollow for the busloads of excited school children and township youth as ANC propaganda is spoken and popular music performed for unattentive throngs of young people with a new freedom and privilege to throw away. Politics is wasteful when it is departed from the masses and cannot compose a meaningful message to the future of the country – the youth!


Township youth are bussed in from all over. Politicians speak of real multiracial unity, but we are the only white people in the entire stadium. Speeches talk of 1976 and the youth movement, but there is no real remembrance or understanding of the past events inspired by youth. It has become less a national holiday and more a day wasted on youth, who are unguided in their development. ANC politicians talk of “all to the polls” but there is no real attempt to register youth and get them active in the governmental process. The youth were there for the pop music show as opposed to the meaning of June 16th 1976, those who died, or what it represented for their country. It is a day that has become a market opportunity for many to sell food, clothes, candies, and anything else. It is a day that has become more of an excuse than anything. An excuse for youth to skip school, to leave home, to do things their parents may not approve of, to hear popular music. An excuse for the government to feign caring about the youth, to spout their slogans, and to give lip service to their ideals. An excuse for many to forget the past and waste the future.

Reflections: 17 July 2009
The day rang hollow for me and my understanding of South Africa history, present, and future. Everything I wrote I still believe, especially now with the World Cup coming ever closer, I can only see it as another wasted opportunity. The government scrambles to hide its poor and failed systems, workers have to strike to get a fair wage, politicians have a field day with what this all means for South Africa, but again it is the masses; the majority of the population that suffers or is forgotten.
"It is best to rely on the freely given support of the people"
- Nelson Mandela

With Mandela Day being today, Madiba's 91st birthday, the world recognizing the imprint that one man left on his country and the entire world community. The problem, much like last year's Mandela Day, was that it was a publicity event. Yes, it was a time to honor a great man and inspire others to action, but it was as if he was begin used, ushered around to coordinate yet another large money making event. Let's not forget what Mandela did for so many people, let's not forget those still in so much need across South Africa, the continent of Africa, and the world.

16 July 2009

why there is no doctor: conclusion & works cited (12)

The sea of gravestones near Zonkizizwe was almost unimaginable. I would not have believed it myself if I had not seen it firsthand. This scene conveys the real implications and impacts of HIV/AIDS on a health care system and a country that has been stripped, divided, and neglected by apartheid.

While I often asked why there is no doctor, I was able to track down a traditional medicinal doctor who seemed to see no patients as well as the private clinic doctor who did not seem to care about providing real health care to the residents of Zonke. Writing has been done on where there is no doctor and what to do when there is no doctor, but the number one question in South Africa is why there is no doctor. This question is answered through history: apartheid, oppression, denial, and failure to recognize a crisis. The reality of apartheid health policies continuing to affect Black populations and responses to HIV/AIDS can be seen firsthand in the Zonkizizwe informal settlement.

Health was a weapon of apartheid and it worked. Denying medical access and training to the Black majority has kept the population in submission even 16 years after the end of apartheid. The critical period of 1993-2000 saw the new democratic government with its hands tied behind its back. There was no way that the health care system could be so dramatically scaled-up to meet the human and social needs of the HIV/AIDS crisis. As Seedat stated in Crippling a Nation, 1984, “Health in South Africa is inseparable from the economic, political and social structure of the apartheid state.” The health and HIV/AIDS realities that can be seen Zonkizizwe are direct result of apartheid’s legacy. HIV/AIDS in South Africa is not a direct result of apartheid policies, but the impact of HIV/AIDS and the health care system of South Africa is still inseparable from its apartheid past.

Works Cited
Beinart, William. “Labour Migrancy and Rural Production: Pondoland c.1900-1950.” In
Black Villagers in an Industrial Society, edited by Philip Mayer, pp. 81-108. Cape Town: Oxford University Press. 1980.

Boseley, Sarah. “Mbeki Aids denial ‘caused 300,000 deaths.” Guardian News UK. 26 November 2008. .

Chirwa, Wiseman Chijere. “Aliens and AIDS in Southern Africa: The Malawi-South Africa Debate.” The Royal African Society. African Affairs 97:53-79, 1998.

E. O. Nightingale, K. Hannibal, H. J. Geiger, L. Hartmann, R. Lawrence and J. Spurlock. “Apartheid Medicine. Health and Human Rights in South Africa.” Committee on Health and Human Rights, Institute of Medicine, National Academy of Sciences. Vol. 264 No. 16, October 24, 1990.

'Forced removals in South Africa 1977-1978', paper prepared by IDAF for the United Nations Centre Against Apartheid, No. 44/78, Oct. 1978, p.9.

“HIV and other STDs. Chapter 3, Part 1” Population Reports. Population Information Program, Center for Communication Programs, The Johns Hopkins School of Public Health. Volume XXIV, Number 3. November, 1996.
http://www.infoforhealth.org/pr/J45/j45chap3_1.shtml.

“HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm.

J Yawitch, Betterment. “The myth of homeland agriculture” SAIRR: Johannesburg, 1981, p.86.

Kon, Zeida R. and Nuha Lackan. "Ethnic Disparities in Access to Care in Post-Apartheid South Africa." American Journal of Public Health. December 2008, Vol. 98, No. 12.

Lodge, Tom. "The RDP: Delivery and Performance" in "Politics in South Africa: From Mandela to Mbeki", David Philip:Cape Town & Oxford, 2003.

Lurie, Mark N., Brian G Williams, Khangelani Zuma, David Mkaya-Mwamburi, Geoff P Garnett, Michael D Sweat, Joel Gittelsohn, Salim SAbdool Karim. AIDS:17 October 2003 - Volume 17 - Issue 15 - pp 2245-2252.

Packard, Randall. White Plague, Black Labor: Tuberculosis and the political economy of health and disease in South Africa. University of California Press, 1989.

Palitsza, Kristin. "A Burden that Will Only Become Heavier." Inter Press Service News Agency. May 28, 2006. http://www.ipsnews.net/africa/nota.asp?idnews=33396.

Posel, Dorrit. “Have migration patterns in post-apartheid South Africa changed?” 4-7 June 2003.
http://74.125.95.132/search?q=cache:4Oor9pRwaTkJ:pum.princeton.edu/pumconferenc e/papers/1-Posel.pdf+the+economic+of+apartheid,+labor+migrations&cd=1&hl=en&ct=clnk&gl=us&client=firefox-a.

Seedat, Aziza. Crippling a Nation: Health in Apartheid South Africa. International Defence Aid Fund for Southern Africa, London, April 1984.

“The Demographic Impact of HIV/AIDS in South Africa - National and Provincial Indicators for 2006” Centre for Actuarial Research, South African Medical Research Council and Actuarial Society of South Africa. November 2006.

“The uprooting of millions, forced removals.” For their Triumphs’ and Tears. ANC, 1983.
http://www.anc.org.za/books/triumphs_part1.html#3back1.

UNAIDS 2006 Report on the Global AIDS Epidemic, Chapter 4: The impact of AIDS on people and societies
http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2006/default.asp.

UNAIDS 2008 Report on the Global AIDS Epidemic. http://www.unaids.org/en/KnowledgeCentre/HIVData/GlobalReport/2008/.

Appendix A

08 July 2009

why there is no doctor: harsh realities in zonkizizwe (part 2) (11)


(photo: Zonke Testing Day banner on the back of a van used to transport people to the clinics)

While working in Zonke, a fact that shocked me was that an HIV-positive person can only access ARV treatment [for free, otherwise it is very expensive] if their CD4 count is below 200. This is official South African government policy and numerous studies have shown that accessing treatment earlier has greater long-term health benefits as ARVs are meant to be taken life-long. A World Health Organization (WHO) study in 2008 outlined four clinical stages of HIV progression. The WHO recommends that when a patient hits stage three with a CD4 count below 350, life-long ARV treatment should be started. Starting patients earlier negates complications later. However, in South Africa once the CD4 count goes above 200 again, treatment is stopped, which allows for greater complications and the need for new strains of ARVs. This year a push to increase the CD4 count threshold for treatment was rejected by the National Health Council on the grounds of affordability (85).
Prof Robin Wood, director of the Desmond Tutu HIV Centre at the University of Cape Town, is among the clinicians who have been calling for the South African government to raise the standard of treatment set out in its guidelines. However, he pointed out that better guidelines would be meaningless without improving the quality of care and access to services (86).

Professor Wood brings everything back to perspective. Anyone can call for greater access and more treatment, but if there is no distribution system for health services and care then what is the point. It would be like having a big supply of pizzas and no delivery drivers. This is the problem in many former “homelands,” townships, and informal settlements. There are inadequate or non-existent delivery systems for health services and treatment and so in areas where the HIV/AIDS crisis is most critical, there is no system to address the problem.
Today was the 2nd half of Prevention in the HIV/AIDS course. The kids are incredibly receptive with questions, comments, and the desire to learn more. We will be covering Treatment and resources this Friday. Celumusa did a great job of translating and really getting the course lessons through to the kids. Later in the evening she talked with us – her passion and drive to get people tested and aware and knowledgeable is amazing and so admirable with all she has been through. She is so excited about a Zonke testing day, the HIV/AIDS class, working with the staff and community to make more people talk and not be afraid to talk. Today she told the kids that she was HIV positive and they all did not believe her at all – they asked her to cross her heart that she was not lying. I could tell from the first class that the kids were learning much more than they had before beyond what HIV and AIDS stands for (87).

Much of the work at the center and the work that needs to happen in Zonke is HIV testing. Once tested you can learn how to take care of yourself, your children, and your community. When I asked Celumusa why people don’t test she said that people don’t know that they can live with HIV. So many people are involved in risky behaviors, she said, they have family members die from HIV/AIDS, but don’t test themselves. She also noted that pregnant mothers are tested and are given tablets, but not told their status. Testing is critical and we began working on this by planning a Zonke Testing Day for July 31st.

As I began organizing for the Testing Day, I came into contact with more of the health services available in Zonke. There are a number of traditional doctors and surgeries in Zonke. I can only imagine that this is because there is such a lack of other health services. Celumusa and others have bad perceptions of traditional medicine: evil, it kills people, and the traditional healers are crazy people. I was still having no luck finding any doctors, until I finally caught a traditional doctor in his office. He ran a clinic that was more Western than others and was supposedly trained by the government in traditional healing, but his office was empty every time I visited – no patients (88). Why are there no doctors?

Across the road from his office was a private clinic run by a group of Indian doctors. I also had a difficult time finding them, as did many Zonke residents. I was able to visit the private clinic only when Celumusa had to schedule an appointment for her baby. The private clinic had become her last option that she was sure to see a doctor. This says a lot for the health care system in Zonke (and other overcrowded settlements and townships left over from apartheid era) that the poor will pay to see a private doctor because the government health services are unreliable. Celumusa said they always give injections at the private clinic. Yet again I wonder about the quality of care. The clinics give painkiller tablets and the private clinics give injections (antibiotics?). If care is inadequate and access to ARV medication is beyond the ability of most, then the extended scenes of cemeteries become less shocking.
In the past 2 weeks, 3 people have passed because of HIV and AIDS that we have been directly informed of because the Buthelezi family has been close to the deceased – a father, an aunt, and a neighbor. Living in an HIV positive community is so different when you can fully understand the impact of just one life (89).

It was as if I had seen the walking dead. The prospect of death is so intertwined with life in Zonkizizwe that the author who wrote that South Africans attend more funerals than weddings was supported by my experiences this summer. The hardest hitting example was with the passing of the father of one of the families at the center. Three of the children attended the center. The oldest was 17 years old and was taking care of her frail father as he withered away, making sure her younger brother and sister were going to school, and attending school herself. This small family had already lost their mother to HIV/AIDS. The burden of disease was not met by the health care system or any the government response. The burden of disease rests completely on those who are affected and they do not have the resources to help themselves.

A critical aspect of combating the effects of HIV/AIDS in South Africa is education. As one of my goals over summer I developed an HIV/AIDS curriculum, based off of the Peace Corps Lifeskills curriculum, that the youth could share with the friends and families as peer educators. The spreading of knowledge is a powerful first step in giving people the resources they need to prevent HIV/AIDS. It is especially important when there exists no other means to access this information. The Zonkizizwe schools are under-funded and teachers are under-trained. This translates to the lack of a teacher for the Lifeskills curriculum and therefore the lack of knowledge on sexual health and HIV/AIDS. VVOCF is beginning to fulfill a service where the government is horribly failing.
All of our kids were tested, plus about 20 others. In all over 60 people tested. […] The community and guardian support was incredible. There were a few positives that we expected from already young mothers […] and unexpected bad news surprise […] Many good surprises came out of the day as we learned of many negative cases that were expected to confirm our worst nightmares (90).

Year - Number of HIV Tests (*from clinic 2)
2006 - 128
2007 - 246
2008 - 412

The success of solutions driven by citizens was best evidenced by the culmination of the HIV/AIDS peer education courses, health classes, and the death of a father in an area wide testing day. I had taken the lead in organizing the testing day with the clinics, MSU study abroad volunteers, and various local organizations. Because of the stigma attached and sensitivity of the issue I was a bit nervous when the day came. July 31st 2008, the first Zonke Testing Day was a day of success fueled by the youth at the center. And while the numbers of people testing have made steady increases, the reality remains that the majority of those who need treatment after testing will not have access. Many in the generation just older than these youth mocked or scoffed at the testing day, but our kids were set on it.
We really are building a new generation of freedom fighters - not afraid of stigma, talking about sex, ready to be tested, and not about to turn a blind to HIV/AIDS. These young people stood today with a powerful support base of each other evidenced by yesterday's action and the larger community is taking notice. The youth continue to give me hope and pride in being allowed to take part in such a community action (91).


The realities of Zonkizizwe paint a vivid picture of the effects of apartheid on health care for the majority of the South African population. The health system operating in Zonke is the ground zero of the failures of post-apartheid government policy to address the far-reaching impact of HIV/AIDS.

Notes:
85. “South Africa: Funding shortfall threatens treatment programme.” IRIN/PlusNews. 2 April 2009. http://www.irinnews.org/report.aspx?ReportId=83762
86. Ibid.
87. Hill, Alex B. Journal Entry. 30 June 2008.
88. Ibid, 17 July 2008.
89. Ibid, 6 June 2008.
90. Ibid, 31 July 2008.
91. Ibid.

Coming next: Conclusion

05 July 2009

why there is no doctor: harsh realities in zonkizizwe (part 1) (10)


(photo: Clinic #1 in Zonkizizwe, serving zones 1-4)

From May to August of 2008, I interned with an organization called Vumundzuku-bya Vana ‘Our Children’s Future’ (VVOCF). The organization is located in Zonkizizwe (Zonke), an informal settlement south of Johannesburg closest to Germiston. The informal settlement is best described as a peri-urban area much like a shantytown with convenience stores. Some live at a lesser degree of poverty than others, but everyone is impacted by HIV/AIDS.

I […] learned more about the extent of HIV/AIDS in Zonke. The intern coordinator reminded us that the statistic of students at MSU that have an STD is 1 in 4. We are only lucky that HIV/AIDS did not enter the mainstream population. Here in Zonke 1 in 4 people is HIV positive. The family at the center is more so affected by HIV/AIDS and now they work to care for children who come the center affected by the virus. There is still a very high stigma and a terribly ineffective ARV program. Many people refuse to get tested or even consider the idea. Each child at the center either has HIV […] has lost parents from AIDS or related illnesses or has not yet been tested to know. There are many who should be tested, but are not. […] It has come to my attention that much of what the government does here looks good on paper and on banners, but there is a huge, massive disconnect in implementation (78).

Zonkizizwe is a snapshot of post-apartheid health care development failures. It was founded when a group of displaced people set up shacks on a farmer’s land so that they could live closer to potential places of work. Many times the South African government tried to remove them, but they kept rebuilding. This is a story different than that of the Black townships or Bantustan “homelands.” Zonkizizwe was an area not meant to be inhabited by anyone, let alone poor Blacks. Understandably the story of health care here is one of an even greater lack of access. Informal settlements had no budgets of their own to even attempt to build their own health infrastructure and even if they did it would likely have been destroyed during forced removals. Under apartheid, health services would have been incredibly difficult to come by.

Everyone waves from their steel-corrugated shacks, children smile and get excited, parents and elders are welcoming - looking out over the shanty town roof tops that extend as far as the eye can see in each direction, you can't help but wonder that within this poverty and desolation mixed with laughter and happiness - what potential can be harnessed, what community action can be inspired to make South Africa's future brighter by and for those who live here (79).

My goals as an intern with VVOCF were HIV/AIDS education, HIV/AIDS peer educator training, and assistance with nonprofit organizational development. I was very glad to be able to focus my strengths and interests in the work I did. I also worked to formulate a rough community health assessment based on my interactions with people at the VVOCF center, neighbors, visits to the clinics, and interactions with Zonkizizwe residents.

Now Zonkizizwe has two primary health care clinics to serve its roughly 250,000 people. Health services are all free through government funding, including immunizations and treatments. However, the issue does not become access to treatments, but rather quality of care. The director of VVOCF, Celumusa, said that all the health clinics do is give out painkiller tablets for everything (80). She said she often just goes to the chemist [pharmacist] to tell them what is wrong and get something that will actually help. This appears to be a direct outcome of apartheid health policy. The lack of trained medical professionals, notably doctors, leaves local health workers with no better option than handing out painkillers. Quite possibly the training of these health workers remains inadequate as well. Zonke is an area much in need of the RDP’s action, but all that can be seen here are RDP building supplies for new houses.
“You can see people die, sitting at Natal-spruit.” - Celumusa (81)

The closest hospital to Zonke is in Natal-spruit, about a 30-40 minute taxi ride away. If you live in Zonke, this is the closest place to get ARV medications since the clinics are “not certified” yet to distribute (82). There is another hospital nearby, but the taxi fare is more costly and it takes longer to get there. Residents of Zonke don’t necessarily have the time or money to take a day to travel to the hospital even if it is critical to their health. Those who go to Natal-spruit notice a different level of care. People die waiting, people in great pain are not attended, people in need of good health care cannot access it. At Heidelberg I was told the staff rush to help you and are much more caring (83). The Natal-spruit hospital is set to be closed soon and a new hospital will be built in Extension 6, which is in Sandonga, much closer to Zonke. Maybe with this new hospital the level of care and access to care will increase, especially in regards to ARVs accessibility.

Notes:
78. Hill, Alex B. Journal Entry. 15 May 2008.
79. Ibid, 13 May 2008.
80. Ibid, 6 June 2008.
81. Ibid, 29 May 2008.
82. Ibid, 10 June 2008.
83. Ibid.

Coming next: Harsh Realities in Zonkizizwe (part 2)

01 July 2009

between first and third: conflicting world desires


(photo: Global Worship Center Vosloorus, South Africa - home to the black elites and british neo-missionary colonizers)

This is a topic that I have been thinking about for a very long time in relation to my development studies. While in South Africa this became extremely evident as I sought a more simplified life closer to people and many of the people I encountered sought a life that could be had in the country I had just left. What follows will be based on the noted and bullet points that I made on 2 June 2008.

First's desire to return to simplicity:
- be unburdened by technology, communication, and fast-paced life
- experience difference that is removed
- leave 1st behind/ out of mind for some time (vacation)
- something missing from 1st --> true community, self-discovery

Third's desire to gain complication?
- technology, materials, cars, Ipod
- false ideas of US --> "nigger," media, hip hop, gangsterism
- leave 3rd behind in pursuit of new opportunity/ life (forget past)
- something missing (adequate schools, health, family, country)

13 October 2008 Reflections

Those to travel to 'developing' countries, who experience poverty, and who realize that there is a better way seek to simplify their lives, this is the goal of a conscious 'first' worlder. I sought to be unburdened by technology and communication and the fast-paced life. In the 'third' world I have experienced a difference that is all but removed from the 'first' - or rather attempts are made to hide the difference: poverty, lack of, etc. I wanted to leave the 'first' behind, put it out of mind for a time. In the 'first' I always feel as if something is missing; true sense of community is gone and what else. In the 'first' it is so easy to be wrapped up in society and systems and just the way things are, that opportunity for self-discovery is negated.

So if the goal of the 'first' is to achieve simplicity. Is it the goal of the 'third' to gain complication? This is a long running debate within the development field among other fields of study. The 'third' seeks technology, cars, MP3 players, and the material things that I tend to leave behind. The 'third' holds false ideas of the 'first' (and vice versa), but the 'third' does not have the opportunity as the 'first' does to engage in world discovery. Many people in the 'third' world want to leave it all behind in pursuit of new opportunity offered by the 'first.' There is also something that is missing in the 'third,' but that tends to come at a higher cost, it is much more than self-actualization and discovery. What is lacking is health care systems, schools, infrastructure, family structure (orphans of disease and war), and adequate living necessities.

The conflicting world desires between the 'first' and the 'third' leave a hole unfilled. Many argue that through development world desires are made to conform as everyone seeks a life of happiness and wealth through materials.

3 June 2008
Sunday we went to church with Thuli, a friend of Celumusa's, who she met at the Library. Thuli is a wealthy South African, went to University and her husband works for the UN or the government or something. We were to meet some good people to help the center at her church and a social worker.

We entered an incredibly live [musical] arrangement with a very vibrant choir. The Global Worship Center; the first thing I noticed was that everyone had a BMW, Mercedes, new Toyota, etc. This was the secluded enclave of wealthy South Africans; the nu-riche of South Africa. The pastor and founder was there this Sunday "out of his busy schedule" and he said, "I like to show-off at church!" Church is where you must show-off. It seems he founded this wealthy enterprise on his own love of music and dance (and fame). We learned at the invitation only lunch with him afterwards that he studied Chemistry at USC in the US - why start a church in South Africa after that? His sermon was taking Bible passages out of context and applying them to owning a credit card now. He spoke of the poor using credit cards, denouncing materials and working for others in his own new suit, probably a fancy car out back, he has a second home in Pretoria, a daughter studying at UNISA and just loves the US.

We had met the black African elites of South Africa. Very educated, knowledgable - debates on politics and world oil in the economy - and very taken aback that we lived and worked in Zonke - "Oooo, what an experience, huh?" Was this the real South Africa? At any rate the church is a great place to make connections in-country. The social worker, Christine, is a great NGO asset, even if the church promotes hypocrisy - nothing new. They even had their own bottled water and were indoctrinating their children to be "soldiers for christ."

On Monday we planned the drama. Headed to the Library where internet happened to work very well and found a great assortment of books. The Library here is full of books on important people and events in South African history and social justice. The Librarian tried to get me a girl friend, but he failed - mostly because he was a shady character. Later we ran drama/ acting exercises with the students which was great fun.

Today we headed back to Germiston - again - to take care of some business. I was able to blog, SCOUT BANANA is growing and staff is working well during summer. We went to a stationary store that had a white (British?) shopkeeper and almost all white management staff. He treated Celumusa as our "girl" instead of the Executive Director of an NPO that she was. We will be working on coaching her so that she has the confidence to command the room from her past days as a domestic worker. Mostly a successful trip - field day tomorrow.

Notes:
Today was also Pension Day, when the government gives out all the checks for the elderly, children, orphans, and the disabled. It is like a massive market day all over the country and it is very difficult to get around in Germiston or Zonke. In Zonke the main street is filled with street vendors with everything and anything to sell.

There are municipal strikes happening because the Mayor was caught by his wife with another woman. He used government money to cover the cost of the lawsuit, etc.

Yet another rainstorm complete with thunder and lightning today. "It never rains in Zonke," said Rachel (retracted statement) The rains are nice though and remind me of Michigan summer weather.

4 June 2008
I very much desire and long for the style of community and human interaction of many African countries, which is greatly missing in the US - there is a cold, calculated contempt for all others born on the beauty of self-advancement and a wanton individualism. [bred by a false exceptionalism] It is too often forgotten that you can never get anywhere alone and through working with and for others that you gain greater meaning and association in life.

The best example of this dream community I have found mirrored in African history and my own personal experiences. You always greet everyone on the street, neighbors are extremely well known that property lines really don’t matter, most everyone knows everyone in the community and help each other when needed – but the plagues of modernity and globalization threaten to tear that apart. Crime, materialism, drugs, self-advancement, personal over community – but who am I to speak against the oldest running practice in the world, globalization can be good. Who am I to say that desires for modern life, convenience and technology are not good?

The gap between the “1st” and “3rd” world desires hinge on privilege. I seek a simplified life, a sense of community, an absence of technological wonder, for a human face, to leave America behind for some self-discovery. At the same time I see the African communities I visit caught up in popular culture, music, media, movies, slang, technology, and wealth – do they just not see or know the complications this all brings?

I often dream of denouncing the system, backpacking my days on the generosity of others, and not worrying about the ills of structure. So privileged that I can even think of this, I know the communities I visit have no ability to even fathom this dream – burn my money, take almost nothing, and live in the natural world – seeking seclusion in a shrinking world. And as I have stated before, my travels to African communities are short lived and I can easily pick up and leave, whereas the people here have no choice and no privilege to do anything of the sort.

Yet this still does not deter me from continuing this dream quest of seclusion from society structure that shames me to meet real people and experience the world without the weight of America or anything its ‘culture’ brings. But is that something that can really be avoided? Am I not just running from my own rendezvous with my own ‘harsh’ reality? Is it so despised as to run from it?

30 June 2009

why there is no doctor: post-aparthied health, the burden continues to get heavier (9)


(photo: View of Zonkizizwe with mountains in the background)

The South African health care system was in crisis during the apartheid years and that fact has not changed almost 15 years later. According to the American Association for the Advancement of Science and the Physicians for Human Rights organization, the South African health care system not only limited access to health services for Blacks, but also created an environment in which abuses could and did occur (70). The Bantustan homelands have been incorporated back into the unified free South Africa and these areas remain the most underserved. These areas had their own separate health departments under apartheid with 300 local authorities in charge (71). Now these separate departments are under the authority of 9 different provincial health services leaving health care in South Africa fragmented.

In essence there were, and still are, two different health care systems in South Africa. One system is public and accessed by the majority of the population. The other system is private and subsidized for the few who can afford it. During apartheid the majority of the health budget went into developing this private health system for those living in urban areas and those privately insured (72). This disparity remains true today, as Blacks still have limited access to health services. Economics also continues to drive this disparity as most doctors choose to enter into the private system for better pay and better facilities.

The lack of an adequate health care system for the majority of the population as a result of apartheid policies has exacerbated the ability of medical practitioners in responding to the HIV/AIDS crisis. "HIV patients might soon account for 60 percent to 70 percent of hospital expenditure in medical wards," says HEARD researcher Nina Veenstra (73).
Already, about half of all patients admitted to hospitals in South Africa seek care for HIV-related illnesses, while the numbers of HIV-positive patients in paediatric wards are even higher, she added. […] As the numbers of AIDS patients grow, there will be a greater demand for skilled health workers, medication and hospital facilities.
South Africa already suffers a shortage of health workers, due in large part to unattractive working conditions. Many posts for health workers remain vacant, notes a study by a national research organisation, the Durban-based Health Systems Trust (HST) (74).

The HST and other researchers have estimated that only 13% of all patients who are in need of ARV treatment are receiving it (75). This is in large part because of the lack of health workers. Where apartheid denied Blacks adequate training for medical professions, there is now such a lack of health workers that a government ARV treatment plan can’t even be carried out because there are such limited human resources (76). Along with the lack of health workers, a recent study found that 13% of health workers who passed away between 1997 and 2001 died of HIV/AIDS-related diseases (77).

Notes:
70. Kon, Zeida R. and Nuha Lackan. "Ethnic Disparities in Access to Care in Post-Apartheid South Africa." American Journal of Public Health. December 2008, Vol. 98, No. 12, 1.
71. Ibid.
72. Ibid.
73. Palitsza, Kristin. "A Burden that Will Only Become Heavier." Inter Press Service News Agency. May 28, 2006. http://www.ipsnews.net/africa/nota.asp?idnews=33396
74. Ibid.
75. Ibid.
76. Ibid.
77. Ibid.

Coming next: Harsh Realities in Zonkizizwe (part 1)

23 June 2009

why there is no doctor: what happened to reconstruction and development? (8)


(photo: This office in Zonke is responsible for RDP work - not much happens here)

Beyond AIDS denialists creating inadequate treatment programs, the rebuilding and scale-up of South Africa’s health care system has been very slow since the ending of apartheid. The main driver of scale up of health service infrastructure was the ANC’s Reconstruction and Development Programme (RDP). In its first White Paper of 1994, the RDP noted: “Health services are fragmented, inefficient and ineffective, and resources are grossly mismanaged and poorly distributed. The situation in rural areas is particularly bad” (66). Between April 1994 and the end of 1998, the RDP built 500 new clinics which gave an additional 5 million people access to primary health care facilities (67). The RDP had an incredible set of goals to match the incredible odds the country was up against, but many still had criticisms. Many note that the successes of the RDP are overshadowed by the enormity of the HIV/AIDS crisis.
Critics of the RDP argue that access to healthcare only improved slightly under the RDP and that, even with moderately improved access, standards at many medical institutions declined rapidly. They cite, in the first place, that usage of healthcare facilities increased by just 1.6% between 1995 and 1999, and that even these modest improvements have been eclipsed by the advance of the AIDS pandemic and other health epidemics such as malaria. Between 1995 and 1998 life expectancy of South Africans fell from 64.1 years to 53.2 years, with AIDS patients sometimes occupying up to 40% of beds in public hospitals. This, say critics, is indicative of a "public health system... in crisis" rather than one undergoing positive transformation. Equally troubling has been declining quality of services […] for example, that in Soweto 950,000 patients attended primary healthcare clinics in 1994 where they were seen by 800 nurses -- but by 2000 the number of patients had spiraled to about 2,000,000 while the number of nurses had fallen to just 500 (68).

The difficulties of apartheid have transferred over as the country has attempted to rebuild. There remain serious deficiencies in trained health workers, even regressions. More people are using health services, but more health services are not readily available. More and more people need access to treatment for HIV/AIDS, but the inadequacies in health service infrastructure combined with denial policies have limited that access. The RDP White Paper only had one small section on AIDS, Section 2.12.8 reads:
Sexual health and AIDS. A programme to combat the spread of sexually transmitted diseases (STDs) and AIDS must include the active and early treatment of these diseases at all health facilities, plus mass education programmes which involve the mass media, schools and community organisations. The treatment of AIDS sufferers and those testing HIV positive must be with utmost respect for their continuing contributions to society. Discrimination will not be tolerated. AIDS education for rural communities, and especially for women, is a priority (69).

The numbers speak for themselves and the RDP has failed to achieve its intended goals. The biggest difficulty seems to be that the RDP and health infrastructure were not taken seriously. When the new ANC government was elected the RDP was its own department, but then slowly was scaled back to its own program and now RDP programs exist within other governmental departments where priorities are not on health services or HIV/AIDS.

Notes:
66. “Health Care.” The Reconstruction and Development Programme. White Paper, 1994.
67. Lodge, Tom. "The RDP: Delivery and Performance" in "Politics in South Africa: From Mandela to Mbeki", David Philip:Cape Town & Oxford, 2003.
68. Ibid.
69. “Health Care.” The Reconstruction and Development Programme. White Paper, 1994.

Coming next: Post-Apartheid Health: the Burden Continues to get Heavier

21 June 2009

why there is no doctor: denial is the first step (7)


(photo: downtown Zonkizizwe, South Africa)

Since the early 1990s, Mbeki had turned his back on scientific evidence linking HIV as the cause of AIDS. Mbeki’s stance on the cause of AIDS is the largest contributing factor in the South African government’s failure to scale-up treatment. In 2000, Mbeki called together a group of scientists including a group of ‘dissident scientists’ to discuss the cause of AIDS (55). Later that year at the International AIDS Conference in Durban, he spoke publicly rejecting the accepted science that HIV causes AIDS and instead focused on the need to alleviate poverty in Africa as a way to combat AIDS (56). He said the cause was poverty, bad nourishment, and general ill health while also noting that more Western medicine was not what Africa needed (57).

Since his public statements, Mbeki and the South African government have been hit by a backlash of criticism from the international community and Mbeki has remained silent on the topic. The year 2000 was the same year that the Department of Health launched a five-year plan to combat HIV/AIDS. However, Mbeki’s statement and the lack of strong governmental support led to much “foot-dragging” (58). Mbeki had turned down grants, funding, and free medicines to scale-up the treatment program as a result of his denial. Now a recent Harvard study has placed impact numbers with Mbeki’s denial claims. The authors of the study estimate that more than 330,000 people died unnecessarily in South Africa and that 35,000 babies could have been protected from HIV-infection as a direct result of Mbeki’s HIV/AIDS policy and denial (59).

In 2002, with international pressure growing, the South African High Court ordered that nevirapine, which combats the spread of HIV from mother-to-child, be made available (60). Sadly despite offers of free and cheap antiretrovirals (ARVs), the South African government was hesitant to offer the medicines and only distributed in two test sites. In 2003, the government approved a plan to make antiretrovirals publicly available and by 2005 there was at least one service location for AIDS-related illness in each of the 53 districts (61). However the program did not reach enough people and the HIV prevalence rate among pregnant women was recorded at 30.2%, a steady increase since 1990 (62). The treatment program was beyond inadequate.

The case for HIV/AIDS treatment and prevention suffered another blow at the hands of South African government leadership in 2006. Former Deputy President Jacob Zuma went on trial for the rape of an HIV positive woman and claimed that having taken a shower afterwards protected him from HIV transmission (63). This only heightened international outrage and pressure on South Africa’s HIV treatment programs. At the 2006 International AIDS Conference in Toronto, UN Special Envoy on HIV/AIDS Stephen Lewis, called the South African government “obtuse and negligent” (64). By the end of the year the government had announced that it was drafting a framework to tackle AIDS and pledged to increase public access to antiretrovirals (65).

Mbeki was ousted from his ANC leadership position in September of 2008 and the interim president appointed Barbara Hogan as the Health Minister. Many saw this as a major turning point in South Africa’s HIV/AIDS policy, especially as the government is working to get antiretrovirals to as many people as possible. Unfortunately, Zuma is set to win the upcoming presidential election and has not made any apology for his false statement on HIV prevention.

Notes:
55. “HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm
56. Boseley, Sarah. “Mbeki Aids denial ‘caused 300,000 deaths.” Guardian News UK. 26 November 2008.
http://www.guardian.co.uk/world/2008/nov/26/aids-south-africa
57. Ibid.
58. Ibid.
59. “HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm
60. Ibid.
61. Ibid.
62. Ibid.
63. Ibid.
64. Ibid.
65. Ibid.

Coming next: What happened to Reconstruction and Development?

Access all entries in this series: Index

19 June 2009

why there is no doctor: hiv/aids in south africa (6)


(photo: Local staff and interns at VVOCF in Zonkizizwe)

The first case of AIDS was diagnosed in South Africa in 1982 among the gay community (47). The apartheid government took minimal actions in response to the virus’ coming. This could be in part due to the violent political turmoil as well as discrimination against the gay community. In 1986 the AIDS Advisory Group was established to respond to the epidemic (48), but nothing of significance can be associated with the Group. HIV/AIDS quickly spread to the heterosexual populations and by 1990 antenatal tests showed that up to 120,000 people were living with HIV/AIDS (49).

It wasn’t until after apartheid laws were repealed that a government response was crafted. In 1992, the same year that a referendum was held on apartheid policies, Nelson Mandela addressed the National AIDS Convention of South Africa (NACOSA), which was to develop a national strategy to cope with the epidemic (50). The National Health Department reported in 1993 that HIV rates had increased by 60% in the last two years and this number was expected to double in the next year (51). This was the groundwork that apartheid had lain for the rapid spread of HIV/AIDS in the next seven years.

The period from 1993-2003 marked the freedom of mobility of more people, which was evidenced by the increase in internal labor migration patterns as well as a severe increase in HIV prevalence. Seedat’s book is rightly named “crippling a nation” because when the government was stabilized and working to develop a response to the HIV/AIDS crisis it was already too late. The HIV/AIDS crisis was poised to take its toll from the detrimental apartheid policies that limited health services, medical training, forced mass migrations of people, and established environments prone to high-risk behaviors.

During this time period, a number of government actions were meant to stem the increasing prevalence rates. In 1994, the Ministry of Health adopted its first national AIDS strategy based off of NACOSA’s work (52). Unfortunately the plan was considered inadequate, poorly planned, and disorganized. In 1995, the International Conference for People Living with HIV and AIDS was held in South Africa and then Deputy President Thabo Mbeki acknowledged the seriousness of the epidemic (53). That same year the Ministry of Health announced that 850,000 people (2.1% of the population) were living with HIV (54). In 1998, The Treatment Action Campaign (TAC) launched partly in response to the failures of the South African government to provide adequate resources to people affected by the crisis.

Notes:
47. “HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm
48. Ibid.
49. “HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm
50. Ibid.
51. Ibid.
52. Ibid.
53. “HIV & AIDS in South Africa: The history of AIDS in South Africa.” Avert.
http://www.avert.org/aidssouthafrica.htm
54. Ibid.

Coming next: Denial is the First Step

18 June 2009

why there is no doctor: scapegoating "tropical workers" (5)


(photo: At the Lesotho border)

As early as 1913, international migrant workers have been brought into South Africa to fill out the labor supply, especially in the mines (42). These workers were called “tropical workers” because they came from countries like Malawi and Mozambique that had more tropical climates and diseases. The mines faced a labor shortage starting in the 1930s and by 1934 over 2,000 “tropical workers” had been brought in on an experimental basis (43). The South African government had difficulties with “tropical workers” bringing in disease and spreading it before 1930 and so there was a certain stigma associated with international laborers. Early tropical workers were blamed with bringing tuberculosis and spreading it within the mines. However, working conditions in the mines and biological susceptibility were not taken into account. Regardless, tropical workers were associated with tuberculosis and that reasoning led the South African government to be wary about reintroducing tropical workers in 1934. The success of these workers and lack of increased disease inspired the South African government to lift the ban on hiring workers above the 22nd parallel in 1937 (44). With the lift of the ban, the numbers of tropical and international migrant workers increased significantly.

Tropical workers entering South Africa numbered 40,000 by 1948, the start of apartheid (45). Between 1988 and 1992, around 13,000 tropical migrant workers from Malawi were repatriated because over a two year period 200 of them had tested positive for HIV (46). The tropical worker who was scapegoated for the spread of tuberculosis was now labeled as the culprit for the spread of HIV to South Africa. Later it was understood that the South African mining industry was working on stabilizing its mining labor supply and HIV/AIDS was used as a way to clear out international migrant workers.

Nevertheless, the increase in numbers of tropical or international migrant workers to South Africa expanded the area where high-risk behavior related to HIV/AIDS could have an impact. The international migrant worker movements from the mines to their home countries and any locations in between likely contributed to the increased prevalence of HIV similar to studies that have proven the same for internal labor migrations. The reach of apartheid’s policies stretched beyond South Africa’s borders and contributed to the deepening of the HIV/AIDS crisis within the country as well as the southern African region.

Notes:
42. Packard, Randall. White Plague, Black Labor: Tuberculosis and the political economy of health and disease in South Africa. University of California Press. 1989, 229.
43. Ibid, 230.
44. Ibid.
45. Ibid.
46. Chirwa, Wiseman Chijere. “Aliens and AIDS in Southern Africa: The Malawi-South Africa Debate.” The Royal African Society. African Affairs 97:53-79, 1998.

Coming next: HIV/AIDS in South Africa

29 May 2009

implications for foreign aid across the continent: the shifting africa policies of china and the usa

The Beginnings of Giants

Philosophies, cultures, histories and ideologies are pushing the agendas of China and the USA across the African continent. The USA is flexing its well-honed military resources to provide counter-terrorism trainings in key countries while China is investing in growing economies in a soft power move that often places them above the USA in local influence. China is working now to change its image in Africa as the international community has raised issues. The USA continues a humanitarian military presence, however there may be a new shift in the USA's Africa policy with a newly elected President. Foreign aid in Africa is influenced by the cultural histories and philosophies of the USA and China.

Asserting its extensive soft power in economics China is quickly becoming a world leader in the current financial crisis: contributing to the IMF, long the bastion of Western power, and pushing for a new reserve currency that is not the dollar. As a full understanding is reached on the financial crisis' effects, China has said it will continue to support emerging African economies while there is talk that the USA will become protectionist. The USA has steadily fallen as a foreign aid leader in Africa and is increasingly using Chinese financial tactics to cope with its own severe economic downturn. Since 2006 the Chinese government has been working to create a less controversial policy in Africa. In supporting human rights and international institutions, will they learn from the USA's Africa policy? A new administration is in the White House and the USA is building a more comprehensive Africa policy. The USA has borrowed ideas from the Chinese policy book on dealing with the economic crisis, will they also look to China in building new partnerships with African countries?

There has been increasing talk and scholarship on the implications of Chinese actions on the African continent especially in relation to the USA’s presence. Many experts and pundits don’t go beyond surface level involvements between the world powers. Scholarship often fails to deconstruct media representations of both China and the USA. The media more often paints China as an evil imperialist nation scooping up African resources. While Chinese actions in Africa are problematic, the USA is not exempt from imperialist or destructive actions in Africa either. Current scholarship fails to delve into the historical philosophies and histories of both China and the USA. Culture and world visions are not taken into account when analyzing the Africa policies of these countries. The respective views and values on moral aspiration, international leadership and “othering” has driven scholarship on the quest for power between China and the USA on the African continent.

*Disclaimer: Below is a full 25 page research paper. Read at your own attention span.

Internationally Related

Within the realm of international relations, both China and the USA are taking more normative approaches to engaging in African affairs. By taking more country specific approaches to engagement and focusing on providing services to people, China and the USA have been working to use more diplomatic actions to gain the upper hand in Africa. The actions of both China and the USA have been problematic when it comes to engaging Africa. China has implemented numerous aid programs, but is seen as hypocritical in its policy of not getting involved a country’s domestic affairs. Some Africanist scholars have noted that the USA’s policy is borrowed directly from European imperial histories. These competing policies both based off of diplomacy have numerous points of contention, but is that reason for China and the USA to not cooperate?
Still, the United States has much to gain from cooperating with China on foreign aid and Africa policy. The US could help China develop a more permanent and transparent aid bureaucracy which would allow Chinese liberals to better promote their interests through the system. Also, the United States should encourage China to play a larger role in the donor community, allowing China to evaluate other countries’ aid programs and being subject to the same level of scrutiny. As major oil consumers, the United States and China also have incentive to work together toward political stability and energy security on the continent.
Very often China is painted as an aggressor on the African continent by Western scholars, however these scholars tend to forget the histories of their own countries and their policies, which are based in colonialism, imperialism, and neocolonial actions. If an approach is taken that builds of off John Fairbank’s call for a re-evaluation of Chinese perceptions and Paul Cohen’s call for a “china-centered” history. The importance of Western governments recognizing their past and rethinking how they perceive a growing leader in international relations cannot be emphasized more.
Our American assumptions about East Asia and our instinctive responses to problems there have been and still are far less conscious and far more blind and culture-bound than we realize…. Too often we have leapt before looking and become partisan in feeling before making a serious intellectual effort to see all sides, including particularly our own side. (John King Fairbank)
This is most relatable to Alexander George’s “fundamental attribution error.” The West (USA) is looking for an enemy within China’s policies in Africa as a way to position themselves strategically. Since the USA looked for the negative in Chinese policy, they found an enemy in China.

The Carnegie Endowment for International Peace scholars who wanted the USA to engage China in more involvement in the international donor community in 2006 were right on track. China has now said that it will become more involved in the IMF and will contribute “within its ability.” China’s efforts to strengthen its standing with the international community are directly in line with its history of diplomacy. Michael Hunt talks of this long tradition of Chinese diplomacy, but it is most important to compare this to the USA’s diplomatic history within the international system.
The IMF […] warned that the $25 billion figure is only a conservative estimate as the situation on ground indicates that more countries will be more deeply affected, outside the 20 countries earlier identified by the body as much hit by the crisis. "The IMF study finds that more than 20 countries are particularly vulnerable to the unfolding crisis. At least US$25 billion in urgent concessional financing will be needed this year in the most affected countries, but much more may be needed given the heavy downside risks to the global economic outlook, and the prospect of more countries being affected as the crisis deepens," said IMF Managing Director, Dominique Strauss-Kahn. He warned that the number of vulnerable countries could double, raising additional financing needs to $140 billion.
As China has said it will continue to support emerging African economies into the current financial crisis , another historic financial crisis should be analyzed. In this current economic crisis China has pledged support within the IMF as the "international community is determined to act together to get through the time of hardship." China is emerging as a strong leader in this current crisis by calling for reform along with their financial support. In contrast, during the Great Depression, the effects were more sever because there was a lack of strong international leadership. Following World War I the USA had gained prominence as an economic player, but was not interested in becoming a leader in the international economic game. A major reason that the USA was not interested during the Great Depression was because financially helping Europe had no short-term gain. Will China take this same mode of thinking? Harold James notes that this will be China’s dilemma in the current crisis, but it appears that China is following their cultural traditions and is coming to the aid of the international community instead of taking an protectionist policy. The current economic crisis seems to be another example of the USA shrinking from an international leadership role. China shows that it is committed to the international community, where the USA is narrowly focused on national interest.

Both China and the USA have taken on more bilateral agreements with other countries as of recent. China most notably, since the 1990s, made multiple bilateral agreements with African (and other) countries in the multiple tours taken by their government leaders. The Obama Administration has taken a very strong stance that its foreign policy will be driven by diplomacy. This also happens to be the Chinese government’s number one strategy to foreign policy.
In recent years, China has begun to take a less confrontational, more sophisticated, more confident, and, at times, more constructive approach toward regional and global affairs. In contrast to a decade ago, the world's most populous country now largely works within the international system. It has embraced much of the current constellation of international institutions, rules, and norms as a means to promote its national interests. And it has even sought to shape the evolution of that system in limited ways.
While it is difficult to gauge Obama’s foreign policy of diplomacy as of yet, significant efforts have been made to meet with world leaders of countries where relations with the USA have been strained. The Chinese effort is measurable and visible over an almost 10 year period. China is growing a network of cooperation across the African continent and the globe while the USA is just beginning to mend broken international relationships and extend a hand to former enemies. Africa is a growing interest for both countries, how long will it be before China and the USA cooperate more closely on African issues?

Before delving too deeply into the nuances and implications of various foreign policies, it is important to understand the origins of Chinese and USA cultural traditions and international involvements.

Invisibly Shared Power

The basis of Chinese international relations begins with the teachings of Fu Xi, author of the I-Ching. The I-Ching’s lesson on the Law of Change and promotion of harmony (yin/yang) governed early Chinese policy where there must be a complimentary balance. A very important concept to understand within Chinese foreign policy based in the I-Ching is “The Principle of Heaven.” This is sometimes called the Rise of the Dragon and teaches about how one should act, whether an individual or a state actor, when the top is reached. In the Chinese tradition, one who reaches the top has two choices: to be arrogant which will result in falling from heaven [the top]; or to assist those below in also reaching the top. This teaching plays into the I-Ching’s “Concept of Hegemony,” which is best explained with the analogy of “a group of dragons without a chief.” In the “Concept of Hegemony” there is no one leader in the international community there would be multiple hegemons that work together to bring more into the “group of dragons.”

This philosophy coupled with the Chinese traditions of a collective societal structure has translated to foreign policy as China works to increase cooperation with many international actors. The diplomatic history of China dates as far back as 3000 BC. However, China was not always so internationally focused. During its history China was controlled and relegated to a lesser status by the British government’s colonial treaty system. The treaty system essentially placed China under the economic control of the British government. Following the end of the treaty system China became more nationally focused. Many scholars such as Sun Yat-Sen, Cohen, and Hunt, write on how building a strong and safe China was the priority that developed as a response to the imperial treaty system which had divided the country and weakened the people by creating widespread poverty.

The ideas of the I-Ching continued to be taught years later by Lao Zi and Confucius. These ideas seemed to pervade Chinese cultural traditions and it is no surprise that they translated into the foreign policy of China. One of Lao Zi’s great contributions to Chinese international relations was on political philosophy. He wrote that the best leaders are known when the people feel like they have accomplished something on their own and the leader has only acted as an “invisible hand” to guide them. This idea is evident in Chinese foreign policy as China seeks to bring other countries up with them into the “group of dragons” and increase cooperation within international systems.

The Rise of Individualism

Needless to say the USA has a very different, and much shorter, history than China. As a country of immigrants the USA developed a cultural tradition focused on the individual. The idea posited by Fritijof Capra that Western societies were very logic based and Eastern societies were more intuition based shows the strong focus of the USA cultural tradition on the productivity of the individual within a growing economy.

The development of the USA into industrialization was fueled in large part by the emergence of the nuclear family. The nuclear family was a result of the large number of immigrants who arrived in the USA as individuals often without any extended family. Talcott Parsons, argues that “the nuclear family fits industrial needs because, on the one hand, it allows families to be mobile and economically independent of the wider kin group; and, on the other hand, it ensures that in an individualistic and impersonal world, adults and children have a stable, if limited, set of affective relationships.”

In the history of the USA the individual has been the building block and has driven the success of the country. Because the USA has such a short history and has built itself from the people and ideas of other countries, it is a country that does not have its own distinct or concrete cultural tradition. It is a cultural tradition that is constantly changing. The best idea that can sum up cultural tradition in the USA is that of “pulling yourself up by your bootstraps.” This individualist fervor can be easily translated into the USA’s foreign policy as it is focused narrowly on USA national interests and is not driven by cooperation with others.

Sino-African Relations

The earliest records of interactions between the Chinese and the African continent comes by way of myth and trade. Somewhere around 1414, the “treasure fleet” of Zheng He landed on the East African coast. He returned with two giraffes, which were gifts from the Malindi King (present day Kenya), which the Chinese thought were “qilin.” Qilin were mythical creatures thought to symbolize a well-governed country or one where a wise man was born. This marked the earliest Sino-African relations based in trade.
The tradition of Chinese-African cooperation grew significantly between 1949 and 1970.
Peking had diplomatic relations with fifteen African states in 1970. Approximately 5.1 percent of China’s imports and exports were in African trade in 1966. By mid-1966 China had promised African countries $350,000,000 in aid, although the sums made available and actually drawn were much less. But these figures are dwarfed by her commitment to finance and build the Tanzania-Zambia railway; China could spend $280,000,000 or more for that project.
This time period marked significant Chinese involvement in African development. This was a period in which the majority of African countries gained independence and began working to develop themselves. Beyond the trade relations that are now ever growing, the political ties have been and remain strong. During the 1960s China provided military and financial to nationalist movements as well as increasing development dollars - $100 million. They also sent 150,000 technicians to implement projects in agriculture, transport, and infrastructure development. China was involved in numerous independence movements. In the build-up to democracy in the Democratic Republic of the Congo, China was providing financial support, but it wasn't enough. After Lumumba was assassinated by the USA CIA, the Chinese demonstrated en masse. Millions gathered in Peking, 400,000 in Shanghai, which solidified the Chinese influence and support for further revolutionary movements. A new regime was supported in Tanzania (1964) until Nyerere took power. Nyerere even adopted the Mao-style uniform. Chinese engineers built a railroad from Zambia to Dar es Salaam, Tanzania showing the Chinese economic might and proving that China was serious in Africa. China supported many nationalist and revolutionary movements (see inset map, Page 9) with arms, money, medical supplies, scholarships, and guerrilla trainings and camps.

In 1971 China received 76 votes for a permanent UN Security Council seat. Of those votes 26 were from African countries and by the 1980s fourty-four African countries had established diplomatic ties with Beijing. These ties soon faded out, but have recently been rekindled in the 1990s and even more recently in 2006. In the third China-Africa forum of 2006, 48 African countries were represented. During the past three years the Chinese President, Prime Minister, and Minister of Foreign Affairs have visited almost 20 African countries in efforts to strengthen diplomatic relations.

China has regained a strong influence in African countries. Their power is unmatched and their recent wave of settlement unprecedented. This is a point of contention for both Western powers that may be afraid of the growing Chinese power and the people of African countries who should be wary of another possible exploiter. The Chinese may have a history of support, development and influence, but that does not justify current action.

Colonial Legacy of the USA

Born of European heritage, the USA’s Africa policy is not far departed from the same heritage. From the early American explorers commissioned by European powers, the USA’s Africa policy has been driven by misperceptions and national interests.
One might ask why the Berlin Conference is pertinent to an examination of modern U.S./African policy issues. The answer, to some may appear elliptical. And that is because we were not a party to that Conference or to the spoils of its outcome. Put another way, the United States was never a colonial power in Africa. And because of that the U.S. had a great opportunity to shape post independent relations between Africa and the West. Indeed, Africans looked to the United States to play a neutral and constructive role in bridging relations with the West.
It was seemingly impossible for the USA to play a neutral role when there was so much to gain from Africa. The USA’s past is inexorably linked to the African slave trade and events that followed, further connections increased with support for Liberia, and exploitation began when its own multinational corporations became wise to the vast natural resources of the continent.

During the Cold War, the USA’s Africa policy was one founded on “Soviet containment.” The Cold War saw USA involvement in establishing proxy wars to stem the spread of communism across Africa. The CIA was involved in a number of controversial coups as well as rebel movements within countries run by governments close to the Soviet Union. As a result of Cold War policy a number of countries are notably still in turmoil: DRC and Uganda.

With the end of the Cold War some have ventured to say the USA is engaging in a “containment strategy” for China and also for the “war on terrorism.” The ideas of containment for China and terrorism has translated into growing misperceptions about Chinese intentions in Africa as well as implications for the delivery of development aid by the USA.

Development Aid

Foreign aid; development assistance; foreign investment; these terms are now gaining another synonym: rogue aid. Rogue aiders are defined as such, "Because their goal is not to help other countries develop. Rather, they are motivated by a desire to further their own national interests, advance an ideological agenda, or sometimes line their own pockets. Rogue aid providers couldn’t care less about the long-term well-being of the population of the countries they 'aid'."

China is now the largest rogue aid competitor. Moises Naim says, "My friend was visibly shaken. He had just learned that he had lost one of his clients to Chinese competitors. 'It’s amazing,” he told me. “The Chinese have completely priced us out of the market. We can’t compete with what they are able to offer'." China can outbid the World Bank in foreign aid lending power! What does this say for the future of the aid community? What does this say for the future of development? Naim gives three simple answers as to why China and other countries are stepping up their aid game. "[...] money, access to raw materials, and international politics." China now rivals OECD countries of the developed West in providing foreign aid. In 2006-2008, China provided over $10 billion in loans to African countries.

Along with the financial crisis, China is becoming a world leader in giving development aid and engaging in development projects, especially in Africa. The USA has in recent years given out more development aid than ever before, specifically in Africa, but this is still dwarfed by Chinese investment in African development. USA development aid is also increasingly controlled by the military. Almost 25% of all development funds are implemented by the military up from just 3%, while USAID has fallen from 65% to less than 40%.

The gradual shift from USAID to the USA military implementing development aid and projects has been calculated. Many believe that the advent of AFRICOM and the shift in development aid funding is a direct response to China’s growth on the continent. One scholar says that the USA is launching a new “containment strategy” for China in Africa via military presence. When asked about the motives of USA development aid, Navy Captain Paul Dies said, "I can tell you with a straight face, and I swear on my mother's grave, our mission here is purely humanitarian. There's no ulterior motive."
The Bush administration has laid the foundation of a new containment strategy for its successor with the establishment of AFRICOM, enabling the United States to leverage more effectively its soft and hard power assets to contain China. The next administration will be forced to confront China's rise and its rapidly expanding influence in Africa. Writing in the November/December 2007 issue of Foreign Affairs, Senator John McCain identified China's rise as a "central challenge" for the next president and cautioned against Beijing's expanding economic and diplomatic relations with African nations Sudan and Zimbabwe. In the coming years, Washington's new containment strategy will likely mature as China's balancing efforts in Africa collide with U.S. interests.
A few authors of African affairs have noted that members of Obama’s transition team are very supportive of AFRICOM as a means to increase diplomatic relations with Africa, but they are quick to note that this is a problematic approach to Obama’s call for diplomacy first. Disproving that there is “no alternate motive” is very easily done when the locations of USA military aid is implemented.

Another side to Chinese development aid investment can be seen in the form of the Chinese population. A recent wave of nearly 750,000 Chinese migrants to Africa are not the first. In the 1960s Mao Zedong sent people to forge political ties with the continent. This newest wave or Chinese people is to strengthen the Chinese claims over raw materials and markets. The head of the China Export-Import Bank has said that he will support this migration with "investment, project development, and help with the sale of products." Mr. Li says,"There's no harm in allowing [Chinese] farmers to leave the country to become farm owners [in Africa]," he added.
Mission of the China Export-Import Bank:
The main mandate of the Bank is to implement the state policies in industry, foreign trade and economy and finance to provide policy financial support so as to promote the export of Chinese mechanical and electronic products and high- and new-tech products, to support Chinese companies with comparative advantages to "go global" for offshore construction contracts and overseas investment projects, to develop and strengthen relations with foreign countries, and to enhance Sino-foreign economic and technological cooperation and exchanges.
The numbers of Chinese migrants has dramatically increased. A large part of China’s development aid policy is that African governments use Chinese contract labor, so the aid funding goes directly back to China. China's work in the DRC is its largest loan out to any African country. There are plans to build a road from Kisangani to the Zambian border and a major railway to connect the mineral rich provice of Katanga to the port city of Matadi. Other funds are set aside to rebuild the deteriorating mining infrastructure. As well as being the biggest loan supplier, China also has the largest building company, China Road and Bridge Construction, owned by the Chinese government, with 29 projects in Africa (many financed by the World Bank or other lenders) and offices in 22 African countries.

A final, but contentious, piece of the development aid debate hinges on Taiwan. When China launched its Africa policy plan in the 1990s, Taiwan was not a huge issue. Now China has provided development aid to six African countries that have switched their recognition of Taiwan. Lesotho and Niger switched their diplomatic recognition to the PRC in 1994 and 1996, the Central African Republic, Guinea-Bissau, and South Africa switched their recognition from Taipei to Beijing in 1998, and Liberia switched recognition to Beijing in 2003.
It is in the areas of development policy, however, that we and others in the West have experienced our greatest failures in Africa. This is so largely because while well intentioned in many instances, we have sought to export our values and ways of doing things to Africa. In both the public and private sectors, NGOs notwithstanding,for fifty years it has been our way or the highway. Our money or no money. For 50 years our aid to Africa has been tied to our own formulations, priorities and institutions. The approaches made by the Bretton Woods financial institutions have not been different. In like manner, the major international financial institutions have dictated the terms of development under the rubrics of partnership and sustainability while excluding Africans from the councils of governance and staff leadership. These institutions, the World Bank,IMF, IFC, and others, have conditioned their aid on structural adjustment and other private sector strategies while shielding themselves from the consequences and accountabilities associated with outcomes and policy failures.
Development aid is probably the area of most contention between China and the USA. Some want to see greater collaboration with the USA helping China reverse its “rogue aid” policies. Others criticize both the USA and China in their implementation of development aid. The Western aid institutions and agency have come under much criticism latterly from withint their own communities. The Chinese take a policy that is very much in line with the idea of bring up many countries to the “group of dragons,” but on the other hand it is often only China that benefits. The USA follows a fairly rigid policy that has specific national security interests at heart and nothing more.

Military Support

Both China and the USA have had long time military involvement on the African continent. From early Chinese military expeditions to exploratory actions of the USA, military presence in Africa is nothing new. China is often criticized for its small arms trade with corrupt African governments. The USA is criticized for attempting to have African militaries do its dirty work through anti-terrorism trainings many of which are held in strategic resource countries. Where the USA has not sent troops, China has increased its number of peacekeepers and has sent active troops of the People’s Army as a way to strengthen diplomatic ties. Oddly enough military support is directly related to development aid.

AFRICOM is seen by some as a milestone in US foreign policy showing that the US actually does care about Africa. I would say this is a great representation of how we have seen Africa throughout our policy writing - only important when the USA has a self-interest or gain to achieve. It seems that the only future for US foreign policy in Africa will be military based. Our 'development' and aid work will be conducted by the military and people will begin looking to the military for aid and assistance. Kenyan columnist, Salim Lone, sums up the fears of many, "The military now is going to be working with civil society, to promote health and education. Africa is going to look at all its development efforts through the lens of the Pentagon. That's a truly dangerous dimension. We don't need militarisation of Africa, we don't need securitisation of aid and development in Africa." The Association for Concerned African Scholars (ACAS) has a comprehensive archive of USA military involvement in Africa. The archive lists that every African country has received military support whether it be supplies or trainings from the USA military, including the USA base in Djibouti.

“Its the oil, stupid!” As the phrase goes, some experts argue that the real reason that China and the USA are engaging in development aid and military support is to access the natural resource wealth of African countries. China has been accused of this in relation to the genocide in Sudan.
Sudan, which now supplies 7 percent of China’s total oil imports, has benefited from the largest Chinese investments. The China National Petroleum Corporation (CNPC) is the single largest shareholder (40 percent) in the Greater Nile Petroleum Operating Company, which controls Sudan’s oil fields, and has invested $3 billion in refinery and pipeline construction in Sudan since 1999.
China has also invested heavily in Angola’s oil development and Nigeria’s. The USA depends largely on Nigeria’s oil wealth, but it seems China is cutting in on the business.

Investment in oil development is one thing, but investment by way of military support is another story. The USA has invested millions of dollars and has conducted hundreds of joint military trainings with African countries. China is accused of fueling genocide against an ethnic minority in Sudan through its small arms sales.
Weapons deliveries from China to Sudan since 1995 have included ammunition, tanks, helicopters, and fighter aircraft. China also became a major supplier of antipersonnel and antitank mines after 1980, according to a Sudanese government official.
The evidence for military support influencing development aid implementation has become overwhelming for both China and the USA. Neither country is exempt from blame in meddling in the affairs of African countries trying to development and build stable economies. Both countries have long histories of military involvement in Africa from colonial times and earlier. Neither country is new to playing with African foreign policy. However what is most important is how China and the USA implement their support. China tends to claim no involvement in “domestic affairs,” but their actions often translate into serious domestic effects. The USA claims to be working towards anti-terrorism (a containment strategy?), but this is often a larger tactic to get closer to the natural resource wealth of African countries. The policies seem very similar, but China and the USA come from different cultural traditions that drive their policy decisions.

Conclusion

The implications for foreign aid both developmental and military, is determined by the cultural traditions of a particular country as well as a long-standing involvement on the African continent.

China builds from a philosophy based on bringing everyone up to the same level. They have had trade relations with African countries since the 14th Century and take pride in having been involved in African liberation struggles. The Chinese traditions that look at hegemony, leadership, and responsibility have translated into their foreign policy actions. The underlying assumptions of Western/ USA academics shows the continued misperceptions of Chinese intentions in Africa. While there are a number of problematic policies, the Chinese government gives responses that follow in the steps of its cultural tradition. With a very long cultural tradition, China works to push cooperation on the African continent, but to what degree is cooperation competition for resources?

The USA is, and has always been, very focused on national interest. If there were no national interest to engaging African countries then the USA would most likely not be there. The serious shift in implementation of USA foreign aid dollars is very worrisome and does not bode well for the future of African development practice. The colonial legacy of the USA’s policy in Africa perpetuates the failures of the past into the future of African development. A re-militaization of Africa is a poor policy for “Chinese or terrorist containment” and must be re-evaluated by Obama. The potential for the USA Africa policy to depart from the detrimental ideas of the Bush administration is very strong under Obama.

While there are problems on both sides of the Africa policies, China and the USA can learn from each other on how they engage African countries. China has an excellent cooperation model and the USA has serious potential to support human rights and accountability. As soon as the Obama administration releases a serious Africa policy brief, scholars and experts can be sure that the USA is committed to a positive shift in the way Africa has been handled. Since the 1990s China has developed a serious Africa policy and for good reason. They now hold the sway of the majority of all African leaders and have access to their resources and markets.

Calls for diplomacy can no longer fall on deaf ears as policies shift, foreign aid is restructured, and economies continue to falter. China and the USA will have to prove to the world that they are ready to build a working world order. A world order where there are multiple hegemons: China as a financially stable elder and the USA as a young and ambitious innovator. There is much that the two countries can collaborate on especially in regards to development practice and foreign aid across Africa. The continent needs renewed policies that see outcomes in an “Africa-centered” view. The world’s giants can no longer use and abuse the African continent, rather they need to actively engage Africa if financial and social woes are to be remedied.

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