Lesotho?s small size and mountainous territory have not protected it from the HIV/AIDS pandemic. Being surrounded by South Africa ? which has a very high HIV infection rate ? has left it vulnerable. In fact, humanitarian workers say they believe the HIV prevalence rate is much higher than estimates from UNAIDS, the United Nations AIDS agency.
Gillian Forrest ? HIV/AIDS coordinator for CARE ? explains why she believes the HIV prevalence rate is much higher than officially reported.
She says, "The latest prevalence survey was done in 2000, but that was done at very limited sites. And the overall estimation of HIV prevalence is 31 percent. But from recent information and anecdotal information it?s probably higher than that. I would say it?s probably closer to late thirties, early forties."
Ms. Forrest says for a small country, Lesotho has a high number of AIDS orphans.
She says, "Lesotho has a population of two point two million. And the number of orphans is probably in the region of 120-thousand."
And as with many other African countries, poverty is complicating the AIDS problem. The CARE official says Lesotho has been dependent on South Africa for jobs.
"There?s been a lot of retrenchment from the mines in South Africa, in post-apartheid South Africa, as South Africa tries to create jobs for its own people," she says. "And what?s happened in Lesotho at the same time, which is maybe positive, is that there?s been a growth in the garment industry. And just for your information, I think your listeners might like this, is that Lesotho is the largest exporter of clothing to the United States in Africa."
But the garment industry doesn?t have jobs for everyone. And each day, many people wait outside the factories hoping for work. The average salary for those who do have jobs is less than 100 US dollars a month. And for those who want to buy anti-retroviral drugs to treat AIDS must spend more than half their salary on the medicine. Currently, the drugs are only available through private doctors. There are no government programs yet.
In Lesotho, it is unusual for someone to make their HIV status known ? stigma and discrimination are the main reasons. But one of those who has is 25-year-old Bolelwa Fako-Falten, who now works for CARE. She says going public about her HIV status was actually not an option.
She says, "I don?t think I wanted to but I was keeping a public secret, you know. Like when I was given my results everyone was there, everyone was listening. It was a room full of people. So, I was told what the results were. So for me to keep quiet it was like, anyway everyone knows, so, why keep quiet about it."
Nevertheless, she says it was quite difficult.
"The first time I spoke about it was when I was tell my cousin after two weeks, I think, after testing," she says. "And she was like, no, no that?s fine; anyway, let?s leave that aside. You?re still our cousin and let?s go on with other things. Let?s talk other things. After that time, after having told her I thought there was a burden that was off me. And I realized it was really working for me to tell others what I was going through."
Bolelwa now educates people about HIV/AIDS, but she says changing attitudes takes time, often a long time.
"It?s like a drop in the ocean, you know. There?s just too much that needs to be done and little is being done around it," she says.
However, she says among those accepting of her efforts are traditional chiefs. They see what HIV/AIDS has done to their villages. She says the chiefs have problems caring for their own families, let alone others.
Also, Gillian Forrest, CARE?s AIDS coordinator in Lesotho, says young people are now taking an active role.
She says, "Young people want to know what their status is because they want to be able to make decisions about marriage and about having children, etc. So, young people are really a lot more aware. There?s really been changes in our program that certainly young people are using condoms when they are sexually active."
CARE has a number of programs in Lesotho to help slow the spread of HIV/AIDS. One is called SHARP, which stands for Sexual Health and Rights Promotion Project. The AIDS awareness program operates in the five main border towns between Lesotho and South Africa, catering to sexworkers, migrant workers and youths. It also provides services such as home-based care and care of orphans.
Another CARE program is the Private Sector Coalition Against HIV/AIDS. It helps the garment industry develop AIDS prevention programs within the workplace.
Also, CARE will soon open a Voluntary Counseling and Testing Center, which will allow people to learn their HIV status.