- by: Emma Durden, University of Cape Town and University of KwaZulu-Natal
Abstract
This paper explores two essential questions related to health promotion and HIV/AIDS education.
1: Do HIV positive health promoters and peer educators have positive effects on students’ health attitudes, behaviours and HIV stigma reduction?
2: Which programme characteristics have better effects on health education performance? The paper seeks to address these questions with relation to the DramAidE Health Promoters Project run at a number of Higher Education Institutions in South Africa. The project makes use of HIV positive young people to live openly as role models with HIV on campus, to break stigma around the disease, increase prevention efforts, and encourage testing for HIV and positive living with HIV. A project evaluation conducted in 2007 included interviewing students, staff and the HIV positive health promoters working at nine campuses across South Africa, and forms the basis for this study.
Introduction
This chapter introduces the DramAidE Health Promoters Project and gives some background on its history and the rationale for its inception, with an overview of the current situation and response to HIV/AIDS at Higher Education Institutions in South Africa. The Health Promoter Project is rooted in the fields of peer education and entertainment education, and this chapter explores some of the theories that inform those practices, as well as an overview of some of the literature on similar projects that employ HIV positive people.
The chapter then explores two areas of study, namely the effect that HIV positive peer educators have on other students, and the programme characteristics that have better effects on health education performance; in an attempt to highlight good practice in the field of health promotion and HIV prevention efforts in South Africa. Some of the data relevant to the DramAidE Health Promoters Project are presented and discussed, with conclusions regarding the successes, challenges and potential of this strategy.
The DramAidE Health Promoters Project
The social impact of the HIV/AIDS epidemic in South Africa highlights the need to ensure that communities band together to deal with all aspects of the disease. Social behaviour change theories suggest that it is most effective to educate, sensitise and mobilise individuals by addressing the community in which these individuals find themselves, and to make HIV/AIDS a community concern (UNAIDS, 1999b). A number of commentators on HIV/AIDS behaviour change interventions agree that behaviour change can only happen in a supportive context where individuals are empowered to act within the group (Tomaselli, 1997; Airhihenbuwa & Obregon, 2000; Papa et al, 2000; Kelly, Parker & Lewis, 2001; Tufte, 2002).
The Health Promoters Project is a project running in Higher Education Institutions across South Africa, where these institutions are seen as able to respond to HIV/AIDS in a strategic and focused manner, as communities that find themselves within other broader communities. It is understood that the Higher Education sub-sector in South Africa may be disproportionately more affected by HIV/AIDS than other sectors, as the majority of students found on campuses across the country are in the in the age group with the highest prevalence of HIV infection (SAUVCA, 2006). According to a 2000 study conducted by the research organisation Abt Associates, the rate of HIV infection at a university undergraduate level was estimated to be roughly 22. This was expected to rise to 33 by 2005 (Thom & Cullinan, 2003). Read more
- by: Tanja E. Bosch - University of Cape Town
Abstract
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.
Introduction
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
- by: C.J. Polychroniou & Marcus Rolle
Malcolm Sawyer ~ Emeritus Professor of Economics. Leeds University Business School
More than a year ago, British voters sent waves of shock throughout Europe and the world economy with their decision to withdraw from the European Union (EU). However, the impact of Brexit on the UK’s economy and its implications for the future of the EU remain contested territory, especially since the conservative government of Theresa May has shown astonishing ineptness so far in terms of the conditions of the divorce. In this interview, well-known British economist Malcolm Sawyer of the University of Leeds provides an insightful analysis on the major issues and questions associated with Brexit, shedding light on what the future may hold for both the UK and the EU.
C.J. Polychroniou and Marcus Rolle: Britain’s decision last year to leave the European Union represents a shattering political development, the effects of which remain incalculable both for the future of the United Kingdom and for the EU itself. But before we explore the political economy of Brexit, let’s start by asking you to explain to us what you believe were the key factors that prompted British voters to seek a divorce from the European Union.
Malcolm Sawyer: The result of the referendum vote of June 2016 was close — 52 percent [voted] “leave EU” and 48 percent [voted] to remain. In any referendum (and indeed other elections), it is difficult [if not] impossible to discern what people thought they were voting for or against. In this referendum, whilst the consequences of a “remain” majority could be perceived as continuation with present arrangements, those of a “leave” majority were obscure — and indeed, the UK government is now grappling with working out what the consequences will be.
For those who voted for the UK to leave, my impressions are that the key factors include:
– The appeal of “take back control,” particularly with regard to immigration and the free movement of labor within the EU. Whilst there appear to be net economic benefits for the UK from immigration, there will be winners and losers, and people’s perceptions may often be of little or no benefits: added to which, hostility towards foreigners.
– The remoteness of the EU, often labelled in terms of “Brussels” with connotations that decisions of the EU were being imposed on the UK without input from the UK. This interacted with the “take back control” and could be stoked up by stories (often false) of decisions made by the EU.
– Disbelief that the UK’s membership of the EU brought economic benefits. The UK’s contribution to the EU budget (a net cost of around ½ percent of GDP) was apparent (though much overstated by the leave campaign), and the benefits for enhanced trade and cooperation much more nebulous. The remain campaign would cite 3 million jobs dependent on trade with EU (again overstated), but that would mean 27 million jobs were not dependent on such trade.
A breakdown of the vote revealed two fractures: a sharp division between young and old, and a huge gap between London and the North. What does the political economy have to do with these two fractures, and what sort of economic policies can be implemented in the future that can heal a divided nation?
The voting patterns with regard to remain/leave can be broken down along a number of lines — a tendency for large cities to vote remain (not just London), two countries voted to remain (Scotland, Northern Ireland) and two to leave (England, Wales). Having a university education tended to be associated with voting “remain,” and the old were much more likely than the young to vote leave (there being overlap between the two in that participation in higher education was much lower in the 1950s and 1960s than in the past two decades).
There appears to be association between socially conservative attitudes and voting leave. Areas of industrial decline appeared more likely to vote leave, [as did] areas where immigration had increased substantially in the past decade (noting that migration from other EU countries rose sharply after 2004 with the entry of the new member states in that year).
There is, in my view, a division between remain voters and leave voters running along the lines of “what matters to them.” A potent slogan of the leave campaign was “taking back control” — applied to immigration (as the free movement of labor places few constraints on migration within the EU), and to the role of [the] European Court of Justice, and more generally, to adoption of laws (though the impact of EU legislation on UK legislation was often grossly overstated by leave campaign), and to some degree, over regulations associated with the single market, and over policies, such as the common fishery policy.
The remain campaign focused on the adverse economic consequences of the UK leaving the EU, and failed to address the issues raised by the leave campaign in connection with “take back control.” Although large numbers were bandied about for the economic losses associated with leave, in proportional terms, the losses were relatively small (less than 5 percent of GDP over a 15-year period, and then as compared with what would have otherwise occurred). If a person’s concern is over perception of a loss of control, and striving to take “back control,” then some economic loss may well appear inconsequential. But also, the leave campaign’s slogan to the effect that £350 million a week (equivalent to around 1 percent of UK GDP) was the cost to the UK of EU’s membership, money which could be spent on the NHS, served as an antidote to the remain campaign’s claims over economic damage from leaving the EU. The £350 million per week claim was much derided as inaccurate, representing the gross payments by UK to the EU and ignoring the money flowing back to the UK for the agricultural support policy, regional and structural funds, and research moneys to universities.
Read more
- by: Leonid E. Grinin & Andrey V. Korotayev
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
… 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
1.
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
