Health Communication In Southern Africa: Engaging With Social And Cultural Diversity ~ Introduction

A focus on Southern Africa as an area where more and better HIV/AIDS communication is needed cannot be better underlined than by recent figures on adults living with HIV (15-49 years): In Sub-Saharan Africa the figure stands at 11%, whereas the global percentage is 3.25% (UNAIDS, 2008). The rise in these figures over recent years can partly be accounted for by the introduction of antiretroviral therapy, which means that statistically people living with HIV have a higher life expectancy.

Still, 67% of the global HIV prevalence in 2007 was accounted for by Sub-Saharan Africa, as was 72% of the global AIDS deaths (UNAIDS, 2008). The HIV/AIDS epidemic in Southern Africa affects women more than men (60% of people living with HIV were female in Southern Africa in 2007; UNAIDS, 2008), especially regarding HIV prevalence among youth. It is within this context that this book wants to consider the role that health communication may play in combating the HIV/AIDS epidemic.

Positive outcomes of health communication
How can health communication benefit the fight against HIV/AIDS? This positive influence may apply at different levels. Communication is an important part of prevention campaigns like in the case of the ABC (Abstinence, Be faithful, use Condoms) motto, which could contribute to a decline in HIV infections. Since the HIV/AIDS epidemic in Southern Africa typically affects women more adversely than men, gender relations form an important contextual dimension of health communication. Prevention messages have to be reinforced by the empowerment of women, enabling them to change their vulnerable position in sexual relations and negotiations.

Prevention and treatment go hand in hand and both aspects should be addressed in health communication. Voluntary Counselling and Testing (VCT) is a desirable outcome for several reasons. If people are infected they can get treatment and guidance. The spreading of infections may be controlled by more knowledgeable and responsible behaviour by HIV-infected people. Being more open about VCT might also change the perceptions of people living with HIV. Health communication can take the form of campaigns for better drug regimens and adequate state support. People living with HIV/AIDS (PLWA) need to take antiretroviral medicine to avoid AIDS, and their Antiretroviral Therapy (ART) compliance might be improved by good instruction and motivation. New media technologies have created opportunities to develop support networks for social movements and non-governmental organisations working to ensure better access to anti-retroviral medicines for PLWA.

The best-known example of such a network in Southern Africa is the one built around the group Treatment Action Campaign (Berger, 2006; Wasserman, 2005). The portrayal of PLWA may be changed in a more positive direction. Mass media and government policies need to be analyzed critically to detect and change negative or undesirable social representations of HIV/AIDS, or of individuals or groups associated with the disease. Health communication may serve to counter stereotyping, vilification or marginalisation of PLWA in sections of society who are seen as undeserving of state support, e.g. prisoners, migrants, asylum seekers, or sex workers (Berger, 2006). Read more

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Health Communication In Southern Africa: Engaging With Social And Cultural Diversity – Cell Phones For Health In South Africa

L. Lagerwerf, H. Boer & H.J. Wasserman (Eds.) ~ Health communication in Southern Africa: Engaging with social and cultural diversity. Rozenberg Publishers/UNISA Press, Amsterdam/Pretoria, 2009

There is widespread global use of technology in medicine and health communication, leading to terms such as telemedicine, telehealth and e-health. A wide range of information and communication technologies (ICTs) is used both in the provision of services, as well as for messaging and communication campaigns. In South Africa, limited Internet penetration has led to increased experimentation with cell phones as a tool for social change. This paper provides a discussion of three of such projects: The Teen SMS Helpline of the South African Depression and Anxiety Group (SADAG); SIMPill which assists patients with compliance to their tuberculosis medication; and CellLife’s Cell phones for HIV programme. The projects are described, and the paper reflects on the general possibilities for using cell phones in healthcare, weighing advantages and disadvantages, particularly in the local South African context.

The global trend of using new technologies in healthcare and health communication has made its way to Africa. A range of healthcare initiatives makes use of palm devices, the Internet, and other information and communication technologies, giving rise to the terms e-health, tele-health, and telemedicine (see Oh, Rizo, Enkin & Jada, 2005, for a literature review on the topic).

While the growing body of literature on this subject explores both the Internet and cell phones as ‘new’ media in the use of health promotion efforts, it is cell phones that are emerging as most popular, and possibly most effective, in health communication on the continent. Internet penetration in South Africa is increasing steadily, but the numbers of people with access to high-speed Internet connectivity here and elsewhere across Africa are probably still too low to allow the widespread success of Internet based applications, outside of telecentres set up specifically for this purpose. Recent statistics indicate that only one in 700 Africans has access to the Internet, versus one in four Europeans (Chakraborty, 2008).

On the other hand, the number of mobile subscribers in Africa has increased dramatically over the last few years. In 2007 Africa added over 60 million new
mobile subscribers and mobile phones represented 90 percent of all telephone subscribers (African Telecommunication/ICT Indicators, 2008). Indeed, cellphone penetration in Africa has increased rapidly since the privatisation of telephone monopolies in the mid-1990s (LaFraniere, 2005). Between 2000 and 2006, the total number of subscribers to cellphone services increased from 10 million to 110 million, in the 24 countries of sub-Saharan Africa, and South Africa had more subscribers to cell phones than fixed lines (Buys, Dasgupta, Thomas & Wheeler, 2008). Similarly, an earlier study revealed that the number of mobile subscribers in 30 Sub-Saharan countries rose from zero in 1994 to more than 82 million in late 2004 and the rate of growth for the entire continent has been more than 58 per year (Mbarika & Mbarika, 2006). Clearly, Sub-Saharan Africa is the world’s fastestgrowing wireless market and the rate of growth for the entire continent has been more than 58 per year (Mbarika & Mbarika, 2006). In South Africa, cellphone use is widespread, particular with the introduction of pre-paid services; and there are over 30 million users (Shackleton, 2007). Read more

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Globalization, Revolution, And Democracy

This article* studies the issue of democratization of countries within globalization context, it points to the unreasonably high economic and social costs of a rapid transition to democracy as a result of revolutions or of similar large-scale events for the countries unprepared for it. The authors believe that in a number of cases the authoritarian regimes turn out to be more effective in economic and social terms in comparison with emerging democracies especially of the revolutionary type, which are often incapable to insure social order and may have a swing to authoritarianism. Effective authoritarian regimes can also be a suitable form of a transition to efficient and stable democracy. The article investigates various correlations between revolutionary events and possibilities of establishing democracy in a society on the basis of the historical and contemporary examples as well as the recent events in Egypt. The authors demonstrate that one should take into account a country’s degree of sociopolitical and cultural preparedness for democratic institutions. In case of favorable background, revolutions can proceed smoothly (‘velvet revolutions’) with efficient outcomes. On the contrary, democracy is established with much difficulty, throwbacks, return to totalitarianism, and with outbreaks of violence and military takeovers in the countries with high illiteracy rate and rural population share, with low female status, with widespread religious fundamental ideology, where a substantial part of the population hardly ever hears of democracy while the liberal intellectuals idealize this form, where the opposing parties are not willing to respect the rules of democratic game when defeated at elections.

Keywords: globalization, Near East, Egypt, democracy, revolution, reaction, extremists, counterrevolution, Islamists, authoritarianism, excessive expectations, military takeover, economic efficiency.

Sociopolitical destabilization may be produced by rather different causes. However, sociopolitical transformations may be considered as ones of the most powerful among them. This may look paradoxical, but attempts of transition to democratic forms of government may lead to a very substantial destabilization of a society in transition. The present article analyzes the relationships between revolution, democracy and the level of stability in respective sociopolitical systems.

There is a widespread opinion that globalization contributes to the spread of democracy. Besides, there is a conviction, which is more widespread among the politicians and ideologists than among the scholars that democracy contributes to a faster and/or more adequate economic growth. The following quotation passionately expresses this conviction: ‘For the past three decades, globalization, human rights, and democracy have been marching forward together, haltingly, not always and everywhere in step, but in a way that unmistakably shows they are interconnected. By encouraging globalization in less developed countries, we not only help to raise growth rates and incomes, promote higher standards, and feed, clothe, and house the poor; we also spread political and civil freedoms’ (Griswold 2006).

In this context, many supporters of democracy consider extremely disappointing that sometimes democracy does not work properly and the waves of democratization get weaker. Samuel Huntington (1993) called the period of a fast spread of democracy in the 1970s – early 1990s ‘the third wave of democratization’. On the threshold of the twenty-first century, many researchers noted that the number of democratic regimes ceased to grow and that it would be a dangerous intellectual temptation for the democrats to consider that the world is inevitably moving towards some final natural democratic state (see Diamond 1999, 2004, 2008). In this situation, the trend has strengthened which promotes democracy in all countries with non-democratic or partially democratic regimes. This trend, on the one hand, is based on the global geopolitical goals of the USA and the West (see, e.g., Brzezinski 1998), and on the other hand, relies upon an active support of a broad ideological and informal movement. And this justifies the efforts to support democracy and to encourage democratic opposition for the purpose of increasing chances of victory of democracy in case of the crisis of authoritarian regimes (Diamond 2000). The intensive efforts led to a number of interventions and color revolutions. Read more

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Reshaping Remembrance ~ The Eating Afrikaner: Notes For A Concise Typology

eating is one of the principal forms of commerce between ourselves and the world, and one of the principal factors in constituting our relations with other people.[i]

On the glamorous and the mundane

Of course the mouth is the entrance to an exit, about which, as Dean Swift would tell you, one might also be concerned; but for the moment we can sit on that subject, leaving the phenomenology of its outbreathings to make the reputation of some Sehr Gelehrter Prof. Dr. Krapphauser, or Swami Poepananda. Om![ii]

Versfeld’s joke resonates with Wilma Stockenström’s somewhat grim image of a human being: ‘behaarde buis van glorie en smet’ [hairy tube of glory and smut].[iii] At one end of the tube, one could say, a human being ingests less or more elaborately prepared earthly sustenance, as the everyday patty or as paté de foie gras, in a ritualised or ceremonial manner, only to return it to the earth at the other end in a humbler form and mostly in an unceremonious fashion. Indeed, it is a trajectory ‘van glans én van vergetelheid’ [of the glamorous and the mundane].[iv]

This thought alone should be sufficient to put into perspective the quest for an original and essential Afrikaner kitchen. Curiously enough, this line of thinking is pursued to absurd lengths in current fascistoid confabulations about Afrikaner ethnic identity: the ‘smut’ and the ‘glory’, the abject and the heroic, are regarded as elements comprising a self-sustaining feedback loop of ethnic preparedness. The violence of colonialism, the road-kill of history, so to speak, should not be rejected or forgotten by the Afrikaner volk, but ritualistically embraced and imbibed in order to build up strength for what is envisaged as a renewed struggle for self-preservation, under a perceived threat of future ethnic violence.

Inasmuch as these bizarre fantasies are motivated by self-preservation, they constitute, paradoxically, an example of a general weakness in the Afrikaner culture, including the food culture. This debilitating weakness is the result of a misconception of what might command attention and respect: only the glorious struggle and shining surface of nationalist preparedness. In perceptions of this nature the ‘smut’ aspect is fully subsumed under the ‘glory’ aspect. The humble, the abject is not valued in its own right, but only embraced if it can serve a higher, more heroic purpose.

The gist of my speculations in this essay is that it is precisely the inflated attention and respect for the ‘glamour’ and for the moment of permanence, a narcissistic moment, which undermines the Afrikaner culinary tradition from the inside. To illustrate this, I wish to present for consideration a number of notions and practices within specific sections of the Afrikaner community; consideration not by just anyone, but particularly by the purgative and imaginative spirit of the late Martin Versfeld. It was he, who, in his wise, humorous and mischievious essays, presented his calvinistic fellow-Afrikaners with a sensual ethic of eating and cooking, an ethic where the splendour and the simplicity, the glamorous and the mundane of eating and cooking are poetically intertwined. Moreover, it is an ethic which contains both the permanence and the transcendence, of the kitchen and of the table, within a horizon of attention and respect. One could object that Versfeld lights up this whole horizon with the glory of god. Nonetheless, my answer would be that the glory of the kind of god Versfeld believes in seems to me a far more appealing option than the glory of an ethnically exclusive tribe. One reason for this appeal, is that he can easily recognize his god in the gods of other cultures and enrich and modulate his faith with wisdom from a variety of sources.[v]

The big eat

We can never be festive if we wish each day to be a feast. Where everything is festive nothing is festive. … It is gluttonous, perhaps deadly to want that every day.[vi]

In the daily round of contemporary consumer madness it is precisely the rhythm of festivity and everyday domesticity, of indulgence and staple that is corrupted. This corruption is fostered by the images of bedecked tables and plated food presented in  popular lifestyle magazines. The culinary festive and glamorous occasion is celebrated ad nauseum. Should one contend that the contemporary Afrikaner’s way with food has to a great extent become absorbed by the extravagant consumer culture, then one could claim that this could only have happened because, apart from a tradition of domestic simplicity, modesty, even frugality, another tradition, one of over-indulgence and lavish ostentation, is also associated with the Afrikaner culinary tradition. Moreover, this tradition has been an important instrument of social ranking ever since the early days of the Cape Colony. Read more

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Reshaping Remembrance ~ The Windpump

Elbie Immelman[i] tells the story of Piet Olivier and his treacherous windpump in the South African newspaper Die Burger of 9 September 2000. His family had been farming on the Karoo farm Kweekwa in the vicinity of Victoria-West since 1853. Because the farm of 29 000 morgen (about 60 000 acres) was situated on the route between Victoria-West, Pampoenpoort, Carnarvon, Williston and Calvinia, it served as a point of call for the British patrols who had to feed their horses and take in fresh water supplies. Piet’s wife, Chrissie, managed to turn these stopovers to account, however. Whenever she saw dust rising from the transport road, she started to bake bread with the flour she kept hidden in an old well near their house.

When windpumps were introduced into South Africa, Piet Olivier was one of the two farmers in the Victoria-West district who acquired one. He was quite prosperous – he had 204 horses, which the British all commandeered, down to the last cart and saddle horse. To demonstrate their benevolence they allowed him to keep all of four donkeys for his own use, of course with the stipulation that he was not to tend to them or stable them.

But that was not the end of the British soldiers’ generous treatment of the farmer. One day the British raised the dust on the transport road to serve a summons on Oom Piet. The charge: spying. He had been sending secret messages with a heliograph. Although he was taken aback (he did not own a heliograph), he was not going to take this lying down. When a deputation of the Mounted Troopers arrived to escort him to town, he put his foot down and refused to go with these South Africans who had joined the British forces. The British and none but the British were to escort him. The Troopers returned to town tail between the legs, and delivered Oom Piet’s message to the Sixth Inniskillin Dragoons, who had been stationed on the edge of the mountain to the south of Victoria-West since the Northern Cape farmers had rebelled.

Eleven Dragoons duly set off to Kweekwa and ordered Oom Piet to walk to the town. It being beneath his dignity to walk for 40 km while the hated British soldiers were on horseback, Oom Piet once again refused: the Troopers had to organise transport for him. They had not reckoned with Oom Piet’s obstinacy, of course, and so they had to stay the night on the farm, Tant Chrissie having to serve them. The second day on the farm came and went, and on the third day an obdurate Oom Piet suggested they fetch his foreman Hugh Wilson’s cart from Witkranz. If two Troopers were to put their horses before the cart, they could ride in it to town, together with Oom Piet… What the tight-lipped Englishmen had to say to each other and to Oom Piet while they were together in the cart is best left to the imagination; it is enough to say that they took Oom Piet’s advice and temporarily locked him up in town. Later, he was freed on parole but had to while away the time in his tuishuis (a small house in which farmers stayed during infrequent visits to town) in Pastorie Street with his family, reporting to the British twice a day. After the war Oom Piet went back to his farm. One evening he was standing on the porch when he noticed a flashing light. When he and Tant Chrissie investigated, they found out that it was caused by the windpump’s steel blades reflecting the moonlight. And so they discovered a possible source of the so-called heliograph messages. Or so the story goes. Read more

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Reshaping Remembrance ~ Glorious Gables

The correctness of the term ‘Cape Dutch architecture’ has often been questioned, but a better and clearer one has never been agreed upon. Museum director Dr. Jan van der Meulen, in a doctoral thesis at a German university in the sixties, tried to prove that it should rather be called Cape German. As a result he was often referred to as ‘doktor Von der Moilen’.

The ‘Dutch’ of the term was probably introduced by English speakers and must have referred to ‘the architecture of the Dutch period’ rather than suggesting a ‘Dutch’ stylistic origin. Such an origin – apart from a certain German influence, if you wish – can certainly be detected in certain details, like gable design and door and window types, but is not at issue in our context. The Cape was Dutch, and not German. And if there are two things that characterize early Cape colonial architecture (if we must use an alternative term), it must be its highly recognizable quality and its strong homogeneity. Within a few decades the little settlement at the Cape developed a domestic architecture that has an unmistakeably local character, of which the highly uniform elements persisted for over a century and a half – well into the British period, in places well into the second half of the nineteenth century. There may well be similarities with domestic architecture in parts of Europe, but no Cape farmstead or townhouse can be mistaken for anything similar over there, not even in the Netherlands or its other former colonies.

Figure 10.1 The real thing. Photo: author

Due to this high degree of uniformity (the causes of which are discussed further on) it is comparatively easy to describe the main elements of this style. These are, first of all, its standardized plan forms and, secondly, the decorative ‘overlay’, notably the gable. The gable is often regarded as the outstanding feature of Cape Dutch architecture. But this is not entirely correct. A Cape farmhouse without a centre gable (and there are hundreds of them) is still undeniably Cape Dutch. But without what we call the ‘letter-of-the-alphabet’ plan it certainly is not. But granted: where ‘places of memory’ – iconic features – are discussed, the chances are we are referring to the Cape gable. Let us therefore first get the development of the unique wing-type plan formation out of the way, while being aware that, while it is this that makes a building ‘Cape Dutch’, in itself it never became a ‘place of memory’.
The homestead of Navarre between Somerset West and Stellenbosch, built in 1814. The real ‘place of memory’: the face of the house is its gable, not the thatch roof, the casement windows and the H-plan, which are standardized. Read more

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