The Honorouble Minster of Health Lesego Motsumi will receive a tuberculosis (TB)/HIV advocacy document from the Botswana Network on Ethics, Law and HIV and AIDS (BONELA) at 2pm tomorrow (24 March 2009) at the Ministry of Health Building. This presentation will be a culmination of a march organized by BONELA in commemoration of World TB Day in line with the organisation’s TB campaign.

The TB advocacy document outlines concerns from BONELA about infection control at health institutions and correctional facilities; the systematic integration of TB and HIV services and the fact that Botswana is not a member of the Green Light Committee, which assists in access to MDR TB diagnostics facilities and medication.

In recognition of the vulnerability of people living with HIV to TB infection, BONELA has since 2008 embarked on a TB campaign to address several emerging and pertinent issues particularly addressing its efforts towards mitigating the impact of TB on people living with HIV.

More than 500 people in communities have been trained on treatment literacy – including– basic human anatomy, immunology, virology, opportunistic and sexually transmitted infections and ARV therapy. A core cadre of treatment literacy trainers was established in 6 districts to coordinate and sustain the program at district level.

The TB awareness march will start at the National Stadium at 10:30 am and proceed to the Main Mall where an awareness-raising public dissemination campaign will be conducted. The day will end with the presentation of BONELA’s TB/HIV advocacy document to the minister.

The Botswana Network on Ethics, Law and HIV and AIDS (BONELA) invites, health service providers, people living with HIV and AIDS, the media, civil society organizations and other concerned individuals to an awareness-raising march on tuberculosis (TB) on Tuesday 24 March 2009. The march which will coincide with World TB Day commemorations is part of BONELA’s ongoing TB campaign.

BONELA has since 2008 embarked on a TB campaign to address several emerging and pertinent issues particularly addressing its efforts towards mitigating the impact of TB on people living with HIV. Tuberculosis poses one of the greatest risks to people living with HIV and AIDS. Although preventable and curable in most cases, it is the biggest killer of people living with HIV and AIDS. In sub-Saharan Africa, up to 50% of people living with HIV will develop TB, and without proper treatment, approximately 90% of them will die within months. It is clear that the fight against AIDS will not be won without also fighting TB-a reality the HIV community has known for over two decades.

The TB campaign falls under BONELA’s Treatment Literacy programme. Treatment literacy is a model that empowers communities with comprehensive knowledge on issues around HIV/AIDS. This model turns ordinary people into informed advocates for health, enabling them to support the scale-up of treatment in communities and to hold governments and policy makers accountable for the delivery of quality health services.

BONELA anticipates to hold this march in conjunction with networks of people living with HIV and AIDS, HIV and AIDS activists, other Civil Society Organisations and interested individuals. The march will commence from the National Stadium at 10:30 am to the Main Mall.

The Botswana Network on Ethics, Law and HIV and AIDS (BONELA) condemns the recent spate of domestic violence over the past two weeks in Botswana as reported in the media.

As a human rights organization, we are concerned over reports in various newspapers that outline shocking details of violence and the threat of violence in domestic relationships. This week alone, according to The Echo, a famous gospel singer in Botswana made headlines for the wrong reasons after his girlfriend whom he had fatally assaulted died while in hospital.

The Midweek Sun reported on the gruesome attack on a woman currently fighting for her life at Nyangagwe Referral Hospital. In a separate incident, a man was fatally attacked by the uncle of his girlfriend in Lephiri Lands. It is a shame that the deceased is alleged to have threatened to kill his girlfriend and her mother when the incident occurred.

In light of these reports, we call upon the Ministry of Labour and Home Affairs in general and the Women’s Affairs Department in particular to intensify awareness-raising on the issue of gender-based violence as well as education on the Domestic Violence Act.

Through the Act, it is now possible to act on cases or threats of domestic violence. Bonela also encourages members of the public to save lives by being on the alert for cases of domestic violence and report them at the nearest police station or social service provider.

Gender inequality makes women more vulnerable to HIV and AIDS through violence or the fear of violence. This deters women from accessing HIV services, insisting on condom use, and disclosing their HIV status to their partners and healthcare services.

On Sunday 15th March 2009, the esteemed Minister of Labour and Home affairs was heard and seen on Botswana Television saying that whilst touring prisons, no inmate  had  come forth and him to provide condoms in prisons. The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) is alarmed by the content and effect of this statement as it is potentially misleading to the public regarding prevention needs of people in correctional and rehabilitation facilities. Furthermore, the statement may compromise an ongoing dialogue among stakeholders aimed at having a comprehensive national response that targets and plugs gaps in our national response to HIV and AIDS.

The statement, with greatest respect, lacks a proper contextual value as the charge is based on personal observations. We observe that on these tours, the Minister is accompanied by an entourage and that the tours are as public as they can be. In our view, this is not a safe and confidential platform where prisoners can meaningfully engage the Minister regarding their needs. It is to be noted that the Penal Code of Botswana is currently interpreted to criminalize same sex sexual acts. In all fairness, who could expect a person incarcerated for an offense against the laws of the country to ask a government official to provide them with condoms? Interpreted in the usual sense, this would sound like the prisoners are asking the Minister to assist them to commit a crime. We posit that the Government of Botswana is quite aware of same sex sexual acts between inmates in prisons and the Government has been engaged on various levels by BONELA and other stakeholders on HIV prevention in prisons including the distribution of condoms and this process has not borne any fruits. This statement unnecessarily thrusts this issue into the limelight and with controversial nature of issues surrounding homosexuality, it becomes difficult to reverse your opinion and begin to openly support initiatives towards prevention in prisons, including the provision of condoms.

Public leaders are leaders of public opinion and as such, they may mislead society by expressing personal sentiments regarding issues of national importance. As a politician, it is also prudent for the Honorable Minister exercise caution not add political leverage to the issue. In our view, the Minister’s comments are disappointing and misplaced, as, currently, research around the issues of HIV and sexual minorities (men who have sex with men, women who have sex with women, inmates/prisoners and sex workers) and the vulnerability of these populations are increasingly becoming recognized as contributing to the rate of HIV infection in general. Studies so far conducted regionally and Global indicate that many persons who have sex with other same sex persons while incarcerated may not necessarily be homosexuals. Some of these persons practice same sex sexual relationships only for the duration of their incarceration and return to heterosexual sex once they are released back into society where often, wives, girlfriends or husbands and boyfriends will be waiting for them. BONELA reiterates its concern that failure to acknowledge the existence of same sexual relations between prisoners is not only an act of hiding behind one’s hand, but it is also tantamount to refusing to protect the public from HIV infection.

As Botswana prioritize strategies towards preventing new infections, our country is moving with the world trends and now beginning to address the lethal multi concurrent sexual partnerships. The key question that we are now asking each one of our brothers and sisters is ‘who is in your sexual network (break the chain….) Considering this paradigm we perhaps need to honestly confront ourselves with the possible truth that some of the prisoners we refuse to protect with appropriate prevention methods while incarcerated may ultimately make it into our sexual networks and might be bringing with them the risk of HIV infection.

It is perhaps important to ask ourselves what the basis for the Minister’s statement is. As it suggests there is a bigger ongoing dialogue among stakeholders regarding this issue. However, the Honorable Minister’s comments  places more weight on dismissing HIV prevention advocacy efforts by stakeholders rather than the specifics of HIV infection as it relate to prison settings (overcrowding, lack of condoms etc) and the how transmission from prison inmates can translate back to the general society out of prison, how it impact on the HIV and AIDS interventions and programming and measures that can be taken to mitigate the adverse effects in HIV prevention in prisons or lack thereof.

The HIV transmission situation in Botswana prisons is not well documented; as a result, there is currently no evidence to inform program developers of the needs to be addressed. We strongly recommend that research be conducted in a manner that is not threatening to inmates, without the presence of officials to ensure that prisoners are able to honestly express their issues and their needs. It should on the basis of facts gleaned from research that the public can be engaged. We further urge the state to recognize its duty to guide public policy rather than hide behind lengthy processes of consultation with the already biased public as a result of the negative and preemptive comments made again by public officials.

Furthermore, Botswana can learn a lot in terms of how other countries in the region, such as Lesotho, who have the same provisions in the Penal Code as Botswana are affording to provide condoms in prisons as an HIV preventative measure, to adequately respond to HIV and AIDS as a country.

The Botswana Network on Ethics, Law and HIV and AIDS (BONELA) would like to applaud the Government of Botswana for the much needed legal aid service and Law Reform Agency that were recently instituted in the country.

Commenting on this development, Bonela Legal Officer, Uyapo Ndadi said: “As a lawyer who deals with indigent clients everyday, I fully understand what difference to one’s life legal aid can make. I have endured the pain of being unable to help people presenting unassailable cases falling outside our mandate. Such clients would naturally give up their strong and winnable cases because they cannot afford legal fees, which are in most cases exorbitant”.

Bonela is also heartened by the establishment of the Law Reform Agency, a development anticipated to expedite the law reform process in Botswana. “As a legal practitioner, there is nothing as painful as dealing with archaic laws that have no relevance to modern day Botswana. The gaps in our laws open up opportunities for human rights abuses, such as the continued discrimination of employees in the workplace based on their actual or perceived HIV status”, Ndadi said.

Bonela trusts that both initiatives will be expedited and see the light of day as any further delay will amount to condemning deserving inhabitants to inhuman and degrading lives as some lose jobs and houses and often feel emasculated to do anything about it as they cannot afford the high costs of hiring an attorney.

In 2008 alone, BONELA’s legal aid clinic handled 50 court cases of which 30 have been settled out of court and some are still in progress. The cases highlight human rights abuses such as unfair dismissal, stigma, discrimination, wrong HIV diagnosis, denied access to tests and deportation in a specific case, and give proof to the overwhelming need for both legal aid and law reform in the country.

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