Category: Lifestyle

Sex education on a street kerb

Between HIV prevalence statistics, child grants, polygamy, Ben 10s, sexual violence and the annual initiation-school deaths, the medical, moral and economic panics that swirl around black bodies in South Africa are enough to power all the geysers in Gauteng for a month. Perhaps it is with this knowledge of the many panics surrounding all matters black and sexual that enterprising self-proclaimed miracle workers going by nondescript names like ‘Dr Tony from East Africa’ promise all manner of miracle cures for all kinds of sexual problems – from fixing relationship crises to penis enlargements. (For some mysterious reason, these doctors are almost always from East Africa). This social investment in matters relating to black sexuality may explain why on one Cape Town train, the only stickers gracing the walls and roofs of carriages are adverts for penis enlargements and “quick, same-day” abortions (their words). Whenever I take this train, I am uncertain what bothers me more: these doctors’ advertorial monopoly or the logic of having adverts for “quick, same-day” abortions side by side with adverts for penis enlargements.

True, I failed maths in school — which explains why all numbers have a slippery encounter with my mind — but the equation here seems too unfortunate, even for my anti-algebraic mind. I can’t decide whether it is a question of ‘to each their perils’ or an acknowledgement of some correlation between penis enlargements and women’s desperation for backstreet abortions. In this social climate, a roadside conversation about sex and its perils is bound to be tinted with all manner of ideas. But what better place than the Cape to have a random conversation about sex, with an unknown teenager, at 8:23 in the morning?

(Pic: Flickr / Rob Allen)

I am walking to work on a typical Cape winter’s day. Sheltered by my umbrella, I’m listening to an SAfm talk-show on serial killers. Among the panelists is an ex-convict, invited in his capacity as a former serial killer. He clarifies to the talk-show host that, eintlik, he is an ex-murderer. Not a former serial killer. He just happened to have murdered, well, several people.

I feel the presence of someone beside me. Being hyper-sensitised by the talk-show discussion, I almost jump. As I turn to my left, I hear the ultra-polite greeting, “Good morning m’aam”. I respond, as I remove my earphones, slightly puzzled at this young man, about sixteen, a few inches shorter than me, cuddled in a heavy coat, hands in his pocket.

“Ma’am, can I ask you something?”

I don’t know where this is going, and I am puzzled at the polite “Ma’am” laced with the heavy ‘coloured’ Afrikaans accent, but as we walk on, I say, “Okay?”

“Please, I am not being rude, but I want to know: is sex painful?”

Ei? But really now!?! I turn and look into his face, preparing to firmly tell him he is way too young to be trying this nonsense with me, and even for his age-mates, he will need to learn some ‘pick-up’ protocol. But as I look for words, I realise from the serious, slightly shy look on his face that he is not being cheeky. He is actually expecting a serious answer to this question; and from the shy look on his face, he has been pondering this question for a while.

“Yes, sometimes it is. Why do you ask?”

“My girlfriend says it is painful. Is it painful for men too?”

I never! It occurs to me then that I have never asked the men in my circles and life this question. The automatic assumption is that of course sex is always pleasurable for men. It is still drizzling, and my office is a block away. It quickly occurs to me that this is a Dear Sis Dolly moment; and I must respect this young man’s courage to ask this question of a complete stranger. He must have realised this conversation could go very badly. I quickly don my big-sister hat and step into this street-kerb sex-education scenario. I truthfully explain to him that sometimes it is painful for women, but I do not know if it can also be painful for men. I am a big sister/aunt. I tell him the best way around this is to always listen to his girlfriend, and never force her to have sex when she is not ready. I fumble around for polite language for explaining the importance of foreplay to women’s sexual comfort, as he listens attentively. Lastly, I tell him to always be safe and ensure he protects himself and his girlfriend, by using a condom. He giggles at this last part, and shyly tells me he knows about the importance of condoms.

“Good!” I smile back at him. “So, where are you going so early in the morning?” I ask.

To pick up something from his father, who works at our local supermarket.

As we parted ways, my heart ached for this teenager, who had to resort to a stranger on the street to explain sexual matters when he lived with his father. I found this encounter so bizarre that the first thing I did was describe it to my colleague at work because it was so odd that it felt like a hallucination. My colleague had only one question for me: Why is it that of all the people on the streets he decided to ask you?

The jury is still out on this question.

Oh, and now, thanks to my male friends, I have an answer for my young friend on whether sex is painful for men.

11 years ago

Pay, pay and pay some more: Renting in Dar es Salaam

I was born and raised in Dar es Salaam. We locals call our city Bongo – a Swahili slang for brain, and you need a sharp one to survive here.

My mother saved her civil servant salary for about three years to build the house I grew up in. For most of my life, I’ve lived with her in Changanyikeni, a peaceful suburb where everyone minds their own business. Apart from a lack of water in the suburb – we had to fetch some from the university block – Changanyikeni was a pleasant place to call home.

But after years of comfort, I felt like I needed a place of my own. I had spent three months in South Africa living by myself. During that time, independence grew on me – there was no one to answer to about my whereabouts or why I was out late or didn’t want to eat dinner.

And so, at the age of 28, I decided to move out and find a place to rent in Dar es Salaam.

I gravitated towards the suburbs of Sinza, Mwenge, Kinondoni and Kijitonyama, which are coveted among young Tanzanians living on their own. They are close to the city centre and offer plenty of entertainment in the form of bars, night clubs and shopping malls.

(Pic: Flickr / hownowdesign)

My first step was to find the right connections. The renting business in Dar is not exactly conventional. It’s dominated by middle men who connect potential tenants with landlords. You’ll find them every morning lurking around the suburbs, waiting for house-seekers to arrive so they can start pitching.

Most of them are good liars. They will wax lyrical about the perfect house, convince you to view it, and when you do, you’ll realise what an exaggeration “in good condition” and “lovely views” can be. And for every house you walk into, you’ll need to dish out at least $7 to the middle man as a “showing fee”.

I was first taken to Sinza, a middle class suburb full of bachelors and newlyweds who fork out a hefty USD 200 for a 2-bedroom house and at least USD 50 more for utilities. It is a nice suburb but I did not see myself living there. There is a bar, grocery store or night club after every two houses; it’s a party from Monday to Monday. Young people prefer Sinza since they do not have to drive out to have a drink; it can be found just next door.

My next option was Kinondoni but one of the middlemen told me to be very careful since all sorts of dark deals went down here. Drug dealers and prostitutes operate in this area, and the rent prices also put me off: USD 250 to USD 300.

A friend of mind suggested I try the suburb where he lived – Mbagala. Rental prices are very cheap here. For 70 USD a month, a fully fenced housed could be yours to live in.

He invited me to stay over at his place to get a feel of the suburb. The next morning I saw commotion at the bus stand near his house. People were fighting to board the bus to get to work in time. Some were even climbing in through the windows. One man complained he’d never occupied a seat on the bus for the past three months since it’s always overcrowded as people fight to get to work on time. With that, I immediately crossed Mbagala off my list.

After months of hunting for a place of my own, I realised that every suburb has its own drama. I ended up getting a one bedroom house in Kinondoni, away from the shady streets, for USD 150 per month.

I was relieved that my months of hustling were over – but I was also broke. Landlords in Dar es Salaam don’t accept one month’s rent. You need to pay six to twelve months’ rent upfront. If the house you’re renting has damages, the landlord will ask you to organise and pay for the repairs. The money will be deducted from the next month’s rent – or so they say.

I won’t be moving again anytime soon. Independence certainly comes at a cost but I didn’t expect it would involve this many people or so many dollars.

Erick Mchome is a former features writer for The Citizen newspaper in Tanzania. He is the 2011 David Astor Award Winner and worked at the Mail & Guardian between September and December 2011.

11 years ago

Growing up with HIV: Jean’s story

Coming to terms with HIV has not been easy for 13-year old Jean. Shy and soft-spoken, he is not completely at ease with telling others about the complexities of growing up with HIV.

“When I learnt I was HIV positive, my mother’s big sister told me not to tell anyone because there are some people who, when they hear that you’re HIV positive, they don’t want to get close to you,” says Jean. “People here don’t know what HIV is and when they find out you are HIV positive, they don’t want to have anything to do with you.”

Having lost both his parents, Jean lives with his aunt in Abidjan, the largest city in Côte d’Ivoire. Here, adolescents aged 10 to 19 constitute a quarter of the total population and in 2012 they accounted for almost 10% of all new HIV infections in the country[1].

According to Dr Jean Konan Kouamé, an HIV specialist with Unicef in Côte d’Ivoire, such high infection rates can be attributed to “early sexual debut, ignorance about how HIV can be transmitted and limited access to HIV prevention and treatment services”.

According to recent data, 88% of the population has never taken an HIV test[2]. Dr. Kouamé believes that this is “because people do not know that if they know their HIV status they can access a treatment that allows them to live longer and healthy lives”.

Stigma associated with HIV is such that people living with the virus are reluctant to disclose their status even to their immediate family. For children going through the delicate transition to adolescence, this can result in isolation and loneliness, which makes it difficult to access care, treatment and support services available to them.

Jean came out of isolation when he met Cécile Traoré, a support worker with Femmes Actives, a non-governmental organisation (NGO) that provides support to children and women living with HIV. Cécile pays regular visits to Jean in his home. She checks whether he is taking his HIV medication correctly and simply lends him a friendly ear.

NGOs like Femmes Actives play a key role in supporting adolescents living with HIV and emphasising the importance of antiretroviral treatment. (Pic: Unicef)

“Adolescents need social, physiological and moral support, they need someone to confide in and share their life experiences with,” says Cécile. “It’s not easy to support an adolescent because they need to be monitored continuously, otherwise they let things go.”

With Cécile’s help, Jean joined a support group for children living with HIV. The group provides children with a safe space where they can share their experiences, learn life skills and forge new relationships.

“During the meeting, we’re asked questions, we draw, we talk about what’s going on in our lives and we are given advice,” says Jean. “I feel very good, I feel at ease because I’m with children who have the same HIV status as me.”

Watch an interview with Jean below

Adolescence is a difficult period of transition from childhood to adulthood that is characterised by physical and sexual maturation, movement toward social and economic independence, and development of identity.

Barriers to accessing health services
Health services in Côte d’Ivoire are not always equipped to provide care and support that takes into account the specific needs of adolescences living with HIV and that is why this age group is often left in limbo between child and adult care. Only a small proportion of adolescents who are long-term survivors born with HIV have access to antiretroviral treatment, and most receive it through limited numbers of specialised centres in urban and peri-urban settings.

Jean knows very well how difficult it can be to cope with the challenges of being a teenager living with HIV: “If a young person who is HIV positive has no one to support them, they need a lot of support from their family or an NGO, otherwise they are going to think a lot about negative stuff and stress about the fact that they have HIV,” he says.

NGOs like Femmes Actives play a key role in bridging this gap. Thanks to Cécile jean was able to gradually come to terms with his life as an adolescent living with HIV and learn the importance of adhering to antiretroviral treatment. Through the support group, he met other children with whom he can talk freely about common concerns in a non-judgmental environment.

However in Côte d’Ivoire and across the African continent, adolescents face many barriers to accessing health and support services and they are routinely neglected in national and global AIDS strategies.

Opportunities for greater success in reducing the impact of HIV on adolescents lie in increasing demand for, access to and uptake of key interventions. Barriers to access services must be removed, while the social and economic factors that increase adolescents’ vulnerability to HIV must be addressed. Only by making the most of these opportunities, an AIDS-free generation will be achieved.

Chiara Frisone is a communication consult with Unicef’s Africa Service Unit.

[1] Stocktaking Report on Children and AIDS. Unicef 2013

[2] Enquête Démographique et de Santé et à Indicateurs Multiples EDSCI-III. Côte d’Ivoire, 2011-2012. Ministère de la Santé et de la Lutte contre le Sida, Institut National de la Statistique, MEASURE DHS, ICF International.

11 years ago

Senegal on the frontline of the battle with Big Tobacco

Djité Sekou (32) smokes as he passes his nights guarding one of the many high-rise apartment buildings in Dakar, Senegal. It has been eight years since his first cigarette – a Monte Carlo from Morocco – and when money is available he goes through 20 to 30 per day. It is an addiction that can cost him up to a quarter of his monthly income.

Like most smokers in Senegal, he rarely buys a full packet, preferring to purchase cigarettes individually – a sales strategy tobacco companies employ to ensure that even those with limited means are able to afford their daily nicotine.

“If my pocket is heavy, I buy the full packet,” explained Sekou. “If my pocket is empty, I buy four Excellence [cigarettes] at 100 [CFA] francs [US$0.20].”

Sekou is one of a growing number of smokers across Africa. While reliable, up-to-date figures are unavailable, the 2007 Global Youth Tobacco Survey estimated that up to 20% of Senegalese boys and 10% of girls aged 13 to 15 used tobacco products – a number believed to be much higher today.

Oumar Ndao, Senegal’s focal point for tobacco control at the Ministry of Health, says, “This is due to extremely weak legislation that, apart from prohibiting television advertising, demands no restrictions.”

Tih Ntiabang, Africa co-ordinator of the civil society Framework Convention Alliance, based in Yaounde, Cameroon, says advertising focuses “on two groups of people – the youth and women. For the youth, they portray smoking as cool. For women, if you smoke you are emancipated.”

In Senegal, there are almost no restrictions on smoking in public places, and warning labels on packets are small.

The exception is the holy city of Touba, where smoking has been banned for religious reasons since 1980 (15 years before the US State of California enacted its ban on smoking in enclosed workplaces).

Yet with Senegal’s Parliament due to vote on new anti-smoking legislation, the rest of the country may soon follow suit.

If passed, the law would ban all tobacco advertising, restrict smoking in public places, and demand health warnings that cover 30 percent of all cigarette packaging.

Ndao believes that, even if the law could be strengthened further, this would be a “major step forward” and “endow Senegal with one of the strongest [such] laws in the region.”

(Pic: Flickr/Gaffri)

Weak tobacco control continent-wide
With the largest proportion of young non-smokers and the weakest tobacco controls of any other continent, according to the World Health Organisation (WHO), Africa is a lucrative market for cigarette marketers.

Just five African countries have comprehensively banned smoking in public places, according to WHO, while nine – Chad, Eritrea, Ghana, Guinea, Kenya, Madagascar, Mauritius, Niger and Togo – ban all tobacco advertising. Only four African countries – Madagascar, Mauritius, Niger and the Seychelles – meet WHO recommendations for health warnings on packaging.

“In a number of places, there is no legislation at all,” said Ntiabang. “What is really driving this is the tobacco industry strategy to recruit new smokers.”

Yet even where laws do exist, enforcement is a major problem. Senegal’s Ministry of Health has banned smoking in all health centres, but according to the government’s own report to WHO, this has had “no practical impact in reality”.

WHO estimates that, globally, tobacco kills six million people per year, a figure that, without action, could rise to eight million by 2030, with 80% of deaths occurring in low- and middle-income countries.

Taking on the tobacco industry
Many health advocates believe the tide is turning, however, with Kenya, Mauritius, Seychelles and South Africa all having introduced tighter tobacco control laws in recent years. Ntiabang believes these are symptoms of “a changing trend” – but one under threat by the tobacco industry.

The 2013 WHO global report on tobacco use accuses the industry of trying to influence public health policy, exaggerating its economic importance, manipulating public opinion, fabricating support from “front groups”, undermining proven science and intimidating governments with litigation.

“Tobacco industry interference is the number one problem we have in Africa, especially in countries that are in the process of elaborating legislation,” Ntiabang adds. “The tobacco industry interferes in every single stage of this process.”

A WHO official IRIN interviewed agreed: “Every single country in Africa where there is proposed legislation, you find them there.”

According to Article 5.3 of the WHO’s Framework Convention on Tobacco Control, tobacco companies are not supposed to be involved in shaping health policy. But the official said many countries have been swayed by “information given by the industry claiming that they are critical to the economy, and yet the reality is they are just profiteers and are not contributing that much to the economy”.

Senegal has been no exception, says Ndao: “The industry managed to infiltrate the process with strong lobbying of decision-makers.”

In Senegal, industry officials lobbied to soften the total ban on advertising to allow communications at the point of sale, but the government has not ceded. They also pressed to ensure health warnings need not be in picture form, said Ndao, which has been more successful. But the [Senegalese] authorities are trying to resist industry pressure and are “aligned strongly with the WHO Convention” he told IRIN.

A spokesperson for Philip Morris, which controls over 40% of the tobacco market in Senegal and owns a cigarette factory in Dakar, confirmed that the company has “”proactively and transparently” been communicating its opinions to government, “like any other industry”.

While the company “welcomes the proposal for the implementation of a tobacco-control law in Senegal”, it continues to seek amendments to “a few elements” including “the lack of a transition period, the ban on trade incentives for wholesalers and retailers, and the total ban on advertising”.

To Ndao, the incentive is clear: “The industry is losing major markets in Europe and North America, and is seeking refuge in Africa, which explains their strong presence in Senegal.”

Health impact
Ahmadou Dem, surgical oncologist at Joliot Curie Cancer Institute at the Dantec hospital in Dakar, is already seeing the consequences of smoking. He has noted an increase in cancers of the lung, larynx, pharynx, bladder and pancreas.

If nothing is done, the future could be more worrying still, he said. “It will be a catastrophe for our country’s health and economy, because our human and financial resources are limited and cancer care is costly.”

Dem adds that while facilities to treat cancer do exist – offering surgery, radiation therapy and chemo therapy – they remain “largely inaccessible for the majority of patients, who are poor”.

Any efforts to reduce smoking rates in Senegal must include an “ongoing anti-smoking campaign at schools, in businesses, and in the media,” he told IRIN.

Weakening the law
Ndao recognises that, despite the huge public health improvements the law will bring, there is a lot more work to do.

Unless amended by members of the National Assembly, smoking areas will still be permitted in restaurants, bars and hotels, and pictures warnings – considered essential in a country where half of the adult population is illiterate – will be voluntary. Ndao believes parliamentarians will strengthen these areas of the law before it passes.

And the law will not undertake what is commonly regarded as the most effective way of reducing smoking – raising the price of cigarettes. Such a measure has to be dealt with separately through the tax system.

At just $0.80 a packet for an economy brand, and $1.20 for a premium brand, cigarette prices in Senegal are almost 10 times cheaper than in the UK and among the cheapest in the world.

Senegal has chosen not to follow the Economic Community Of West African States guidelines allowing countries to tax cigarettes up to 150% , instead abiding by the West Africa Economic and Monetary Union rules limiting taxes to just 45%.

According to WHO, a 10% price increase for tobacco products reduces consumption by 8% in low- and middle-income countries.

Two years ago, Phillip Morris created a national scandal in Senegal by reducing the price of its Marlboros by one-third. Black market cigarettes from neighbouring countries such as Gambia and Guinea-Bissau also push prices down.

Sekou believes that both a stronger law and higher taxes are “necessary”, especially for smokers like himself. “Senegal has the right to do it. Everyone wants to quit. The more they smoke, the less they eat,” he said.

“For me, someone who struggles to get 1 000 CFA [$2.00] per day, if the price went up – and my wife is next to me, my son is next to me – I wouldn’t do it,” he continued. “Even today paying $1.20 [for a packet] is a problem.

“As of today, I have decided to quit. I got myself into it, and I’ll get myself out of it too.”

11 years ago

Meet the Elephant’s Bikers, Côte d’Ivoire’s version of Hells Angels

Decked out in leather gear, their powerful Harley-Davidsons girded in sleek chrome, the Elephant’s Bikers make an almost surreal sight in the poor and sometimes barren Côte d’Ivoire villages they visit.

As the west African country’s “Easy Rider” team roars into communities where residents are lucky to own a rundown moped, ecstatic crowds typically form to greet them on their journey from the economic capital Abidjan to the industrial port of San Pedro almost 400 kilometres to the west.

Wherever the club makes a pit-stop for supplies, men, women and children flock around the 30 or so bikes and their owners. Young drink-sellers use ageing cellphones to snap pictures of the Harleys and grinning villagers chat to the bikers.

Members of the Elephant’s Bikers club ride near San Pedro. (Pic: AFP)

“We’re sharing a pleasure, a dream. People identify with that. They see that it’s accessible, it’s not just on television,” says one of the bikers, Landry Ouegnin.

“Just because we live in an underdeveloped country doesn’t mean we can’t share this kind of thing,” adds the 34-year-old business manager, who helps run the club of inveterate riders.

The Elephant’s Bikers, created 10 years ago to mark the centenary of legendary American motorcycle maker Harley-Davidson, has about 50 members – mostly native Ivorians, but also expatriates, some of whom have become citizens of Côte d’Ivoire.

The whole gang displays the distinctive signs of a pack like the Hells Angels – bandanas, omnipresent skulls and crossbones, leather jackets with the Harley logo or that of their club, an elephant wearing cowboy boots.

The Elephant’s Bikers club, an Ivorian version of Hells Angels, was created ten years ago to commemorate Harley Davidson’s centenary. (Pic: AFP)

For Jackie Thelen, who leads the club and came from France to take on Ivorian nationality, the regalia is “a disguise” that unites members with “a spirit of brotherhood” like in other such groups scattered around the world.

“You’ll often see a big boss show up with ripped jeans, a flashy belt and skulls even though he’s in charge of a highly rated company. That’s the paradox among Harley-Davidson lovers,” says Thelen (52), who runs a business himself and sports a ring in his left ear.

Benevolent bikers
In Côte d’Ivoire, the bikers are anything but bad boys, in contrast to the reputation of notorious counterparts like the Hells Angels. And their rides are expensive. Including the cost of transport and import duty, the cheapest bike in the club cost four million CFA francs ($8 200), while the most pricey cost 25-million ($52 000).

Such sums are way above the means of most villagers along the bikers’ route, but they sometimes help the people they meet by making donations to schools, medical dispensaries or entire villages.

While some members of the club are not wealthy and assembled their own bikes, most are well off and a few are very rich.

A son of late president Henri Konan Bedie is a member, together with an adviser to a cabinet minister. To protect such prominent figures, paramilitary police follow the pack in a four-by-four truck and occasionally direct traffic.

Once they reach San Pedro, after a trek that began in the rain and has been strewn with potholes, the bikers are all smiles.

“That was wonderful!” shouts Gerard Lokossou (41) at the end of his first outing with the club.

A marketing director of 41 who has ridden with a biker group in the US state of New Jersey, Lokossou says he experienced the same joy being part of the Ivorian horde.

“It gave me a chance to discover a part of the country that I had never seen from that point of view,” he says, as wide-eyed staff from the hotel where the Elephant’s Bikers are staying film the group’s arrival.

Joris Fioriti for AFP