The healthier lifestyle magazine for Africans
Issue 5 – Autumn 2010
FREE
THAT IS THE QUESTION Also in this issue:
How to relax African cuisine
WIN
this iPod!
Role model Thandi’s
PrincessWrap turns heads
TM
Dear Reader, A few months ago, King Goodwill Zwelithini launched a voluntary male circumcision programme as part of a strategy to reduce the spread of HIV in his kingdom of KwaZulu-Natal. The launch marked the end of a ban imposed 200 years ago by his ancestor, the mighty King Shaka Zulu, who felt that too many young men were unable to participate in war because they had septic wounds from circumcision. Today, male circumcision is being actively promoted across sub-Saharan Africa as part of national HIV prevention programmes. In this issue, we examine the emerging link between the circumcised penis and reduced HIV infection risk. And in Your Shout, a Mambo reader gives his personal take on the question of whether African men in the UK should borrow a leaf from their counterparts in Africa, and seek the ‘cut’. In another section of the magazine, we look at tuberculosis (TB), a disease widely acknowledged as common among people who have HIV. With the latest figures showing a significant rise in the number of cases in London, the need to educate high-risk communities about TB has become clear. In his article, Elias Phiri of TB Alert tells us about the connection between TB and HIV, and offers guidance on what can be done to reduce exposure to infection. Finally, we are pleased to announce that Bernie Siu from Stockwell is the lucky winner of the Mambo Prize Survey. For your chance to win a brand new iPod, please see page 9.
The healthier lifestyle magazine for Africans Issue 5 – Autumn 2010 Mambo editorial team Daisy Byaruhanga Charles Kyazze Mary Lima Toju Cline-Cole Fola Rogers-Saliu John Owuor Marc Thompson Joseph Ochieng African communities mass media programme advisory group Dr Charles Mazhude Dr Edwin Mapara Maurice Cunningham Daisy Byaruhanga Anna Aguma Charles Kyazze Marie Tameze Asher Emetananjo MAMBO magazine is funded by, and published as part of, the Pan-London mass media programme aimed at promoting awareness of sexual health among Africans. The programme is being delivered by Terrence Higgins Trust in partnership with the following African organisations: Neovenator Community Organisation The African Eye Trust
Enjoy your copy!
Addington Afro Ethnic Health Promotion Group (AAEGRO) Bantu Welfare Trust Future Builders Information in this magazine is correct at the time of going to press. For the latest information or updated version of this publication, visit www.mambo.org.uk
Joseph.Ochieng@tht.org.uk
Free health promotion skills seminars
Organisational development training
THT and the AHPN/HEAL partnership will be running four health promotion skills seminars between October 2010 and February 2011. For more information please contact Abigail.Okunlola@ahpn.org
This is a free service that helps African organisations to build their capacity and management skills. For more information, please email samuel.cunningham@tht.org. uk or visit www.mambo.org.uk
If you have any questions or comments about this resource, or would like information on the evidence used to produce it, please email feedback@tht.org.uk Distribution of Mambo outside London has been supported by an unrestricted grant from Bristol-Myers Squibb. © Terrence Higgins Trust, September 2010. Code: 0129800 Registered office: 314-320 Gray’s Inn Road, London WC1X 8DP. Terrence Higgins Trust is a registered charity in England and Wales (reg. no. 288527) and in Scotland (SC039986). Company reg.no. 1778149. A company limited by guarantee.
Mambo Autumn 2010
In the absence of an effective HIV vaccine, researchers have been looking at whether male circumcision has any benefits in controlling the HIV epidemic in communities where HIV is widespread. But it is only an addition to other prevention strategies, such as using condoms, sexual abstinence, using drugs to reduce the risk of passing on the virus, and structural and legislative programmes.
Circumcision: It’s no magic bullet By Olubunmi Arogunmati Male circumcision is one of the oldest and most common surgeries practised across the world. It is less widespread today, however, partly due to the ‘westernisation’ of beliefs and lifestyles. The debate about circumcision centres on its potential role in preventing a man from getting HIV. It is a debate that is gaining momentum, as healthcare workers seek out new and more effective ways to control the spread of the virus.
The debate is relevant to African communities in the UK, as it is considered ‘high risk’.
1
• Men who are circumcised can still be vulnerable to other sexually transmitted infections (STIs) such as Chlamydia, gonorrhoea and syphilis. • Circumcision can be very painful, and there is a risk of the cut becoming septic. • It can cause serious psychological problems. • It does not prevent an HIV positive man from passing the virus on to his partner through unprotected sex.
The debate is particularly relevant to African communities in the UK. Although they make up only about 1% of the population, Black Africans account for nearly half of all people diagnosed with HIV. So the question is: should African men in the UK be circumcised in order to gain additional protection against HIV?
The evidence in favour of male circumcision does appear compelling. I am doubtful, however, whether an African man in the UK would consider circumcision as a viable option as here it is relatively easy to get hold of condoms, which are more effective at preventing infections and cause no pain.
The most powerful arguments in favour of male circumcision are that:
In any case, although several studies have reported a link between male circumcision and reduced HIV infection, other studies cast doubt on that link. So my own view is that, for now at least, there is no compelling case for promoting circumcision among African men in the UK. It may protect against HIV, but it is not a magic bullet, and must be considered in conjunction with the other recognised prevention approaches.
• It reduces the risk of acquiring HIV by as much as 60%. • It is a procedure that is only done once and so it is cheaper than other prevention methods, apart from abstinence. • It promotes hygiene, whereas an uncircumcised penis can harbour dirt and bacterial organisms.
The arguments against circumcision are: • It can offer protection against HIV, but a circumcised man can still get the virus as a result of unprotected sexual intercourse.
If you are an African man thinking of getting the cut as an additional protection against HIV, by all means go ahead and do it, but remember that it won’t give you complete protection against the virus or other STIs.
Have you got a health or lifestyle issue that you feel strongly about? Why not share your views with other Mambo readers? Email your name and contact details to joseph.ochieng@tht.org.uk Sentiments expressed in ‘Your Shout’ columns do not necessarily reflect the views and/or policies of Terrence Higgins Trust or its partners’.
2
Mambo Autumn 2010
THE
Michael Okello, Fulham As a sexual health worker, I do not think it is entirely appropriate to rely on circumcision as a barrier against HIV. What men need, in order to avoid getting sexually transmitted infections (STIs), is to practise safer sex, for example by using condoms and not engaging in polygamous relationships.
VOX-POP
Researchers say that men who are circumcised have a lower risk of acquiring HIV through sex. So should we be actively promoting male circumcision among African men in the UK?
Victoria Nakyobe, Harrow
Samson Ojwang, Hammersmith As an African man, I’m well aware of the cultural practices that may put African men at risk of HIV, such as wife inheritance and polygamy. Partly due to these practices, many African men are exposed to HIV. I think circumcision is one measure that could help reduce that risk, so I support the idea of promoting it among the UK African male population.
I support male circumcision. It does not only protect against STIs, it also promotes hygiene, making it less likely that a man will have a health issue around the sexual organ. Yes, let’s encourage more of our men to get the cut.
Rose Akola, Northolt As a mother of two boys, increasingly I think about whether or not I should get them circumcised. Each time I bathe them, I have to pull back the foreskin to wash and ensure it’s clean. I think circumcision would help in this respect. If the researchers are saying circumcision also helps to protect against STIs, I can understand why it may be a good idea to promote it among African men in the UK.
Helen Atim, Shepherds Bush Fletcher Phiri I come from a background wheree circumcision is not widely practised. I think few men from my Malawian community would agree to get circumcised, partly because to them it has religious connotations. If it is to be promoted on purely health grounds, then let it be promoted by members of the community, who will know how to get around entrenched beliefs and attitudes.
I do not agree that being circumcised can protect a man from getting HIV. Actively promoting the practice may encourage men to take risks with their sexual health, such as having unprotected sex. I do accept, however, that circumcision can help with basic hygiene. If it is to be promoted, let it be promoted on the basis of this benefit alone.
Mambo Autumn 2010
3
Auntie Fola s
Dear Auntie Fola, A close friend of mine was recently diagnosed with gonorrhoea. He received treatment for it, but then his GP referred him to a sexual health clinic for an HIV test. Thankfully, he was found to be HIV negative. I am keen to know why the doctor thought he needed an HIV test. What’s the link between the two infections? Adam, Willesden
Hi Adam, The fact is that gonorrhoea and HIV are both transmitted through unprotected sexual intercourse, although HIV can also be transmitted through sharing contaminated needles, blood transfusions or breastfeeding. When a man has gonorrhoea, the urethra (that’s the open tube inside the penis) can become inflamed. The inflammation makes the urethra become tender, and that means that foreign organisms (like the virus that causes HIV infection) can easily penetrate it. So if that person then goes on to have unprotected sex with someone who has HIV, there will be a greater risk of the virus entering his bloodstream.
The incident you described shows why it is important for people who do not know the HIV status of their partner to always use a condom correctly each time they have sex. Condoms are available free from some GPs, as well as from family planning clinics, sexual health clinics and some African community organisations. For more information about where to obtain free condoms, please call African Culture Promotion on 020 8687 0339 or THT Direct on 0845 1221 200 or the African AIDS Helpline on 0800 0967 500. For information about where to get low cost condoms please visit www.freedoms-shop.com
Your friend’s GP clearly thought the fact that your friend had gonorrhoea suggested he had been having sex without using a condom. As we know that HIV can be passed on via unprotected sex, that is probably why the GP advised your friend to go for an HIV test.
The best of African cuisine Liver with herb gravy (Serves 2) Liver is rich in proteins, iron and vitamins, which the body needs for energy and for getting rid of harmful chemicals in the bloodstream. Most people like their liver fried, so here’s a tasty way to serve it up. Ingredients 500gm (1/2kg) cow’s liver
Remove the skin of the liver by tapping it with a knife.
3 cloves garlic, chopped
Cut the liver into thin slices.
1 medium-size onion, finely chopped
Make a marinade by mixing the oil with pepper, garlic, salt and dhania in a bowl.
pinch of salt 1 tablespoonful of ‘dhania’ (coriander) ¼ teaspoon of black pepper 2 ripe tomatoes tomato paste 4 sticks celery, 2 medium-sized carrots and 2 onions, all roughly chopped 250ml water 2 tablespoons of virgin olive oil plus more for frying.
Auntie Fola can help you to find a solution to your sexual health lifestyle problem. Please write to her at: MAMBO magazine, Terrence Higgins Trust 314-320 Gray’s Inn Road, London WC1X 8DP. Your letter should state the nature of the problem, your name and the area you live in.
Method
Place the liver into the marinade for 30 minutes. Heat a frying pan and add olive oil, making sure it thinly covers the bottom, then fry the liver by spreading out the slices evenly in the pan. Turn the liver slices every two minutes until the liver is cooked. Remove and set aside in a hot saucepan. In the same saucepan, add the onions and the tomato paste, and keep stirring until the mixture has turned dark brown and thick. Then add the roughly chopped vegetables and stir for two minutes. Add water and allow to boil for 5-8 minutes. Sieve and season with salt and cream.
4
Mambo Autumn Autum umn n 2010 2
Vienna Vie V iie AIDS SC CONFERENCE REPORT CAPRISA trial results hold promise for African women C CAPRIS
For years researchers have been frustrated at the lack of a breakthrough in the development of a microbicide capable of preventing HIV infection in women. Previous studies, including a large-scale study conducted in South Africa in 2004-2006, produced poor results. So when the researchers from the Centre for the AIDS Programme of Research in South Africa (CAPRISA) announced that their experimental microbicide offered 39% protection against HIV, the audience gave them a standing ovation.
What did the CAPRISA study involve? The study enrolled 889 HIV negative women from KwaZulu-Natal’s rural community and an urban centre and split them into two groups. One group was given an experimental microbicide gel including 1% of the anti-HIV drug tenofovir. The other group received a placebo (a dummy gel that did not contain any active ingredient). The women were asked to apply the gel 12 hours before they had sex and again 12 hours or sooner afterwards. The gel was to be used only once in a day.
A research team from South Africa caused excitement at the recent International AIDS Conference in Vienna when it announced What is a microbicide? A microbicide is a substance that can findings suggesting After 30 months, the researchers substantially reduce the risk of found that 98 women from the group a microbicide could acquiring or transmitting a sexually that took the placebo gel had offer 39% protection transmitted infection, such as HIV, acquired HIV, while only 38 women it is applied in the vagina or from the group that received the against HIV. The CAPRISA when rectum. It’s most likely that it would microbicide tested study could be just what be formulated as a vaginal gel, cream, experimental positive. They therefore concluded AIDS campaigners have foam or ring. No proven microbicide that, on average, the microbicide yet exists on the market. offered a 39% protection against HIV. been hoping for. Why is a microbicide needed? However, until the Most women in developing countries findings are replicated have difficulty using condoms as a barrier against HIV because they in more widescale trials, either cannot afford to buy condoms any celebrations may or their partners refuse to use them. But a microbicide can be applied by be premature. a woman without telling her partner. It can also prevent HIV infection while allowing a woman to become pregnant.
Too early to celebrate There are doubts about the importance of the CAPRISA findings. For example, the adherence rate at the end of the study (that is, how many participants were still using the gel as instructed) was low, at only 39%. There is also concern that women could develop resistance to the tenofovir and then, if they became infected with HIV, would not be able to take the drug for HIV treatment. Past studies of HIV vaccines and microbicides have promised much but delivered little. If the findings of the CAPRISA study can be replicated in larger trials, then the world could be on the verge of reversing the spread of the HIV epidemic. But until then, it’s probably too early to celebrate. You can find more information about the CAPRISA study at www.aids2010.org or www.caprisa.org
Mambo Autumn 2010
5
STRESSED OUT? Many people in the African community in the UK face financial hardship, as jobs have disappeared and welfare benefits are destined for cuts. Poverty, unemployment and ill health can cause serious stress and anxiety. Zhana, a stress management consultant, explains how a simple relaxation technique can help people living with HIV to reduce their stress levels.
Mambo: What made you choose relaxation skills as a career? Zhana: I have always been interested in helping people to find solutions to their problems, whether these are financial, relationship, emotional or health problems. I believe that the keys to solving a problem are taking clear decisions and having the right attitude towards it. Once you’ve mastered the art of clear, controlled thinking, you’ll be in a better position to solve your problems. Mambo: You have been recommending Emotional Freedom Technique (EFT). What is this? Zhana: Anything that is stressful, worrying or traumatic becomes less so if you stop feeling upset or unduly worried about it. EFT is a form of energy healing which involves using the fingers to tap on pressure (or acupuncture) points of the body in a particular sequence, while making positive statements. The human body is made up of electrical systems. Any physical or emotional problems are usually the result of a breakdown in this system. If we tap into those pressure points, we can manage the problem better.
Mambo: How would EFT be of help to a person living with HIV? Zhana: Although we know that there is no cure for HIV, the effects of HIV infection can be managed, primarily by conventional medicine. Similarly, the emotional and psychological effects of HIV infection can be addressed using non-medical approaches.
EFT can, for example, help an HIV positive person to calm down and think more clearly when they are not feeling well, or are having difficulty accessing a particular service. The technique works by eliminating negative beliefs and replacing them with more positive, life-enhancing ones. To demonstrate, using three or four fingers, tap onto your forehead and eyebrows, under the ears and cheeks, and on the shoulders to release the tension in your pressure points. If, as you do this, you recite positive statements such as “I am anxious about my health” or “I understand that I need support and help for my condition”, you will feel better and cope better.
Mambo: How popular is EFT within the African and black and minority ethnic (BME) community? Zhana: EFT has been very popular with white people, but so far it’s not been very popular with black people. For someone to benefit fully from EFT, they need patience and self-esteem. The technique is usually effective after six weeks of practice, but unfortunately some people give it up only after a few days. Mambo: How many times does one need to do the tapping exercise? Zhana: Once or twice a day is usually sufficient. To learn more about the Emotional Freedom Technique, please email Zhana at zhana2002@hotmail.com or for information about the next courses on EFT, please visit www.blacksuccess1.com/ relaxationworkshops.htm
6
Mambo Autumn 2010
Mambo Autumn 2010
‘To cut, or not to cut?’ That is the question... Millions of men across the world have done it, but many millions more haven’t. Now the debate about whether or not it’s good to get circumcised has taken on new importance, with researchers suggesting it helps to protect a man from getting HIV. Not surprisingly, calls for male circumcision have become louder, and in some African countries, governments are encouraging men to get cut. In this article, we explain the link between male circumcision and HIV risk, and examine the relevance, if any, to HIV prevention work with African men who live in London. What is male circumcision? Medically speaking, male circumcision is a term used to describe the removal of the foreskin of the penis using a sharp cutting implement. Men get circumcised for different reasons; it could be for health, cultural, religious or lifestyle reasons. Nowadays, most circumcision is done in the hospital by doctors, but in some developing countries, the practice is still being carried out by elders, often using non-sterile cutting equipment.
How safe is male circumcision? As with all procedures involving cutting up a part of the body, there is a small risk that male circumcision could go wrong. If it goes wrong, the procedure can lead to one or more of the following: • Excessive bleeding • Scars • Ulceration (a wound that doesn’t heal) • Difficulty passing urine • Psychological effects. All these side effects should be treatable by a doctor, although some may take longer than others to treat. The debate about HIV and male circumcision has evolved around whether it offers any statistically significant protection against HIV infection. Lately, the consensus has been that, based on studies of infection patterns in a few African countries, male circumcision can reduce the risk of HIV infection in men by about 60%.
How does circumcision help protect against HIV? Compared with the dry external skin surface, the inner lining of the foreskin (or ‘mucosa’) has smaller amounts of fibrous protein, but a higher density of cells that HIV enters through when it comes into contact with the penis. In laboratory tests, the inner foreskin was found to be more susceptible to HIV infection than other penile tissue. The foreskin can also suffer bruises more easily during sexual intercourse, thus providing an easy route for entry of an organism such as HIV. In addition, the inside of the foreskin is a place where the virus can hide for longer. Researchers say that the tip of a circumcised penis provides little hiding place for a virus such as HIV, and that, because it has become rugged, it does not bruise as easily as the tip of an intact penis. As a result, HIV finds it less easy to enter the body.
How did the researchers arrive at their findings? The circumcision studies were carried out in several African countries, but the main ones were done in Uganda, Kenya and South Africa. The researchers worked with a group of men who were circumcised and another group of men who were not. They found that, over a period, fewer circumcised men had acquired HIV than those who were not circumcised. They then estimated that if all the men in the countries covered by the study were circumcised, about 3.7 million cases of HIV infection would be prevented.
IFF ALL THE MEN IN THE COUNTRIEES COVERED WERE CIRCUMCISED, A 3.7 MILLION CAS BOUT ES OF
HIV INFECTION WOULD BE
PREVENTED
6
7
Mambo Autumn 2010
Mambo Autumn 2010
Although men would be the first to benefit from the reduced risk, over time, the risk would be lower for women, as well. The benefits of circumcision would be most felt in Southern Africa, where the risk of HIV infection is greatest, and lower in regions such as North Africa, where HIV is not so prevalent.
Why are the findings important? The studies are important because they show a pattern linking circumcision to reduced HIV risk. Many researchers and healthcare professionals say the findings provide enough ground for promoting circumcision to men who live in high prevalence countries. They recommend that, where appropriate, voluntary, safe, and affordable circumcision services should be added to existing HIV prevention programmes and that it should be provided as soon as possible. Indeed, already in African countries such as Kenya, Botswana and Zambia, health authorities are encouraging the male population to get circumcised.
G NNALLY FROM MEN ORIGI
NON-CIRCUMCISING
COMMUNASITBEIEINSG
W IT MAY VIEW
AGAINST THEIR
CULTURE
Should African men in London be encouraged to get circumcised? For an adult, whether or not to get circumcised is likely to be a very personal decision. Men originally from non-circumcising communities may view it as being against their culture. Also, for a significant number of men, circumcision may not be a relevant issue because they are already in a stable relationship and do not think they are at risk from HIV; others may be turned off by the fear of the physical and psychological impact of getting circumcised at their age. People who promote male circumcision say that it is more likely to work in communities where HIV is prevalent and condom use is low. Whilst African men in the UK are considered to be a ‘high risk’ group, they do have access to the condom, which is an effective barrier against HIV. For that matter, it is not clear whether a circumcision drive would deliver the desired results.
7
Does circumcision replace the need for safer sex? It is important to note that male circumcision only helps to protect a man from getting HIV from a positive partner; a circumcised man who is already infected will still be able to pass on the virus to his partner via unprotected sex. Also, while circumcision may reduce the risk of getting HIV, it does not offer complete protection. It is important, therefore, that men use a condom each time they have sex with a person whose HIV status they are unsure about. Nowadays condoms are available free of charge from a number of African sexual health charities, some GPs, family planning clinics and sexual health clinics. For information about where to obtain free condoms, please contact THT Direct on 0845 1221 200, the African AIDS Helpline on 0800 0967 500, African Culture Promotion on 020 8687 0339, or call NHS Direct on 0845 4647. If you would like to get circumcised Several hospitals perform safe male circumcision; private clinics also offer the service, although you may be asked to pay for it. If you would like to learn more about male circumcision and HIV risk, please visit www.aidsmap.com
8
Mambo Autumn 2010
HIV V TB The
With over 9,000 new cases ses last year alone, the rise in tuberculosis (TB) infections has serious implications for HIV prevention work in the UK. This is because of the interrelationship between TB and HIV, which makes a person infected with HIV more vulnerable to TB. In this article, Elias Phiri of TB Alert talks about the risks from TB, particularly for people living with HIV.
conne
In the developing world, TB is the leading cause of death amongst people living with HIV. According to the World Health Organisation, HIV positive people are 20 - 40 times more likely to develop TB than people who are not infected, with those with a low CD4 cell count being at greatest risk (CD4 is the name given to a type of blood cells that helps to protect the body against harmful infections). Also, TB occurs earlier than other opportunistic infections in the course of HIV, and it progresses faster in positive people than in negative people; TB is also more likely to be fatal in a positive person if undiagnosed or left untreated.
What are the symptoms of TB? TB is an illness caused by Mycobacterium Tuberculosis bacillus. It is passed on through breathing it in the air, such as when an infected person sneezes or coughs. However, to be at risk, a person would need to be close to someone with infectious TB for many hours.
Common symptoms or signs of TB include: a cough lasting more than three weeks unexplained weight loss loss of appetite fever night sweats extreme tiredness.
Most, if not all of these symptoms are similar to those in a person who has HIV, which makes it even more important for a person with these symptoms to get tested for the two diseases.
Who is most at risk from TB? In the UK, the communities most at risk from TB are those with links to high-prevalence regions of the world, such as Africa, south Asia and Latin America, as well as people who misuse drugs and alcohol. This list corresponds with groups considered to be at risk from HIV.
What is TB/HIV co-infection? TB/HIV co-infection is the phrase used to describe infection with both TB and HIV. People who have both infections could be at greater risk of serious illness, or even death if their condition is not diagnosed early. It is possible for the TB to be treated using antibiotics, although treatment should only be started on the advice of the HIV doctor, particularly if the patient is already on HIV medication. In the UK, it is estimated that 6% - 10% of all new TB infections are in people who have HIV, although there is evidence suggesting the actual rate could be much higher. A lack of awareness about TB, and stigma associated with both TB and HIV may delay or discourage people from seeking help. Delays in diagnosis may also occur when a HIV positive person does access health services; this is because the most straightforward TB tests such as chest x-rays and
Mambo Autumn 2010
THE
9
SURVEY
Fill in this short q questionnaire and yyou could
Win this iPod shuffle!
ection a sputum test only look for the most common type of TB - in the lungs. But TB can affect any part of the body and it is more common outside the lungs in people who also have HIV.
How is TB/HIV co-infection treated? TB is treated using a course of antibiotics. If a person is diagnosed with both HIV and TB, doctors recommend that the TB be treated first. However, if the person’s CD4 count is very low, both treatments can be started at the same time. In the UK, treatment for TB is available at any NHS hospital, and is free regardless of one’s immigration status. However, failed asylum seekers are not entitled to free HIV treatment, unless they were already receiving treatment when their asylum application was refused. Voluntary organisations recognise the importance of raising public awareness about the risks of TB. Leading the efforts is Brightonbased TB Alert, which along with partners such as the African HIV Policy Network, Black Health Agency and Naz Project London are encouraging Black minority organisations to get involved in marking World TB Day. Recently, the organisation launched The Truth about TB, a new website containing useful guidance, information and resources so organisations can become good advocates of TB awareness in their communities.
People affected by TB and HIV can get involved through the TB Action Group The group aims to provide support and advocacy for people affected by TB. For more information, contact Tessa Marshall on tessa.marshall@tbalert.org Organisations can contact TB Alert’s Community Development Officers (CDOs) to find out more about getting involved: North and Midlands, hanif.bobat@tbalert.org; South and East, laetitia.crouzil@tbalert.org. More information about The Truth About TB programme is available at www.thetruthabouttb.org, or www.tbalert.org. For more information about TB and HIV co-infection, please visit www.aidsmap.com or call THT Direct on 0845 1221 200.
The deadline for returning yourr questionnaire aire is 2 28th De December 2010.
As a result of reading Mambo magazine:
Strongly Agree Agree
Yes Strongly & No Disagree Disagree
I know more about sexual health than I did before I can protect my sexual health better I understand better the benefits of discussing sexual health with my partner I know where to go for sexual health service I am more likely to try to find out my HIV status I know I should use a condom with someone whose HIV status I don’t know I realise how stigma affects people who have HIV Thank you. Now please write your contact details here: Name: Address: Post-code: Email:
e’s Last Issu r, e i e winn priz m o fr i Siu Bernie ll. e w Stock
Age:
Male
Female
I got my co copy of Mambo from: GOOD LUC LUCK! Now put your form in an envelope and mail to: The Edito Editor, Mambo magazine; Terrence Higgins Trust, 314-320 Gray’s Inn Road, London WC1X 8DP. Alternatively, you can ffax your form to 020 7812 1799.
10
Mambo Autumn 2010
For the past ten years, she has been helping people to regain their self-confidence and to take control and better manage their sexual health. Now, Thandi Haruperi of consultancy group RestorEgo is launching a fashion brand designed to make women look and feel good. In this interview, she talks exclusively to Mambo Editor Joseph , Ochieng about Yedza, the company behind her new line of ladies head gear. MAMBO:
Most people know you as a training consultant. Is the launch of your fashion line a signal that you are changing careers?
PrincessWrap™ is elegant and beautiful, but it is also an identity statement as well as a fashion statement, a belief statement and a confidence statement.
THANDI: No, not one bit. I am very much still carrying on with my consultancy work. Yedza is something that I’m taking on besides my day job.
MAMBO:
What’s made you go into fashion, anyway?
MAMBO:
THANDI: I have always been passionate about fashion, and it’s this passion that has given rise to Yedza. It all started with my head wrap. As a woman, I like to dress well; it makes me feel good. African women take their head wear seriously. However, for most women, tying a head wrap is a complicated business. That’s why we’ve come up with the PrincessWrap™, a head gear that is half-hat and half wrap. The inspiration to do this comes from Africa, my motherland. Primarily in this venture, we shall be using African materials and craftsmanship; we shall also be promoting African culture in the international fashion scene.
The world is full of head gear. What makes PrincessWrap™ unique?
MAMBO:
THANDI: PrincessWrap™ is unique in that it is easier to put on, as the tying is already half-done; this saves time for the busy woman. That’s what our customers have been asking for.
When and where will the products be officially launched? We have been invited to Lagos, Nigeria, where we shall begin our international launch in early October. That will be followed shortly afterwards by the UK launch, which will take place in London. Details for the London event will be circulated soon.
THANDI:
Apart from ladies’ head wraps, what other products are in the pipe-line?
MAMBO:
Over time, we shall be introducing different ranges of headwear for both men and women. Beyond this, we are offering various culturally inspired fashion and lifestyle products.
THANDI:
How can buyers get hold of a PrincessWrap™?
MAMBO:
At present, it can be ordered from our base in Croydon, but soon it will be sold via the internet. Ultimately, all our products will be available at selected departmental stores.
THANDI:
For more information about Yedza, please visit www.yedza.com or call 020 8090 2030 or mobile 07938 848 035 or 07920 153 153. Email: info@yedza.com
Turning heads
11
Mambo Autumn 2010
Mambo Autumn 2010
11
PositiveLiving How HIV treatment kept me alive When Johnston* was told his HIV test result was positive, he texted a suicide note to his sister. He then walked to the top of the hospital’s third floor stairs… and jumped. Head first! That he is still alive today is more a work of God than sheer good luck, as he tells Mambo editor Joseph Ochieng.
MAMBO: What made you decide to take an HIV test? JOHNSTON: I had been feeling tired and weak, and had sharp pains inside my tummy. The doctor diagnosed kidney disease and suggested an HIV test. I did not think I was at risk, but the result was positive. MAMBO: How did you react? JOHNSTON: I thought: “Here I am, an undocumented immigrant, with a serious kidney disease and HIV. If I die, what will happen to my wife and child in Africa? What will my friends and family say?” Then a clinic member of staff told me that, as an undocumented immigrant, I would have to pay £500 per
month for treatment. I decided that I was not going to die an emaciated and dejected person, so I sent a text message to my sister asking her to look after my child, walked to the edge of the stairs and jumped. MAMBO: What happened next? JOHNSTON: By some miracle, I landed on my side. But I suffered serious internal injuries, including broken ribs, ruptured stomach muscles and bruised internal organs. The doctors treated my injuries, but could not give me HIV medication because of the injuries. MAMBO: Did you tell other people what had happened? JOHNSTON: I only told my sister and my aunt. In the meantime, I suffered multiple opportunistic illnesses: pneumonia, thrush, blocked throat, cough, rash. I couldn’t eat, I lost a lot of weight and I started having hallucinations. And then I was put on dialysis. Those were probably the worst days of my life. The dialysis was very painful and I had to have it twice a week. But then I was taken to St Bartholomew’s Hospital where a doctor
*Not his real name as he has asked for his identity to be concealed.
recognised me and arranged for me to start having HIV medication. MAMBO: How did the HIV medicine help? JOHNSTON: When I started the treatment, my CD4 cell count was just 6. (CD4 are a type of cells that help protect the body against harmful infections. A healthy person has a CD4 cell count of 800 or above). Initially, I would vomit each time I took the drugs, but after a while the vomiting stopped. My health improved gradually and my appetite came back. I also prayed a lot. Then, a health visitor mentioned Positive East, the HIV charity. Staff there got me £200 aid from Crusaid, and put me in touch with a lawyer who convinced the Immigration Court judge to grant me discretionary leave to remain in the UK. I also joined a support group at Positive East and finally started to believe that my HIV infection was something I could live with. MAMBO: How’s your state of health now?
JOHNSTON: My CD4 count is now 850 and my viral load is undetectable. My kidney has healed and, save for occasional stomach pain and high blood pressure, I am generally fine. MAMBO: How much is your improved health due to HIV medication and would you recommend it? JOHNSTON: If it were not for the drugs, I would not be talking to you now. The good thing is that, here in the UK, the treatment is free (unless you are a failed asylum seeker), so there is no reason not to take them. MAMBO: What’s your advice to a newly-diagnosed person? JOHNSTON: Keep calm. The shock will die down and you’ll be able to think more clearly. Also, joining a support group will help to build your self-esteem and confidence. For more information about support groups and services for newly-diagnosed people, please contact First Point on 020 7160 0949, Positive East on 020 7791 2855, THT Direct on 0845 1221 200, or the African AIDS Helpline on 0800 0967 500.
12
Mambo Autumn 2010
Mambo Autumn 2010
12
Focus on HIV testing Getting people tested is increasingly seen as key to reducing the transmission of HIV in the African community in the UK. The SAFER Rapid HIV test is one of a growing number of initiatives that are taking HIV testing closer to people in the community. The service was launched in April 2010 as a partnership between seven sexual health charities, namely: SHAKA Services, Naz Project London, African Culture Promotions (ACP), LEAT, African Advocacy Foundation, Ethnic Health Foundation (EHF) and the North Brixton Islamic Centre (NBIC).
The tests are conducted from the premises of SHAKA Services on 38-40 Kennington Park Road, London SE11 4RS. The clinic is open every Monday from 6.00PM to 8.00PM. Anyone can just walk in and request a test.
TESTING is the only way you can tell if you have HIV
The SAFER HIV test analyses saliva sample from a mouth swap, instead of the finger-prick method used at most community-based services. The machine will show if HIV is present in the sample. Clients whose test results come up positive are then referred to King’s College Hospital for a standard blood test to confirm the result.
For more information about the SAFER Rapid HIV Test, please contact SHAKA Services on 020 7735 6744. If you want information about other HIV test clinics, please contact THT Direct on 0845 1221 200 or the African AIDS Helpline on 0800 0967 500; for West London Centre for Sexual Health, text ‘WLC appt’ to 0778 6201816, and for THT Lighthouse West London call 020 7229 1258.
Do it Right Don’t know where to test?
TALK to us
0800 0967 500 Confidential Helpline
www.ahpn.org/test
English - French - Luganda - Shona - Swahili
email: HIVtesting@ahpn.org
13
Mambo Autumn 2010
Mambo Autumn 2010
13
UN identifies wild plant fuel source in Nigeria A wild plant that grows well in dry areas is set to become a low-cost source of fuel for rural communities. A recent United Nations report said the seeds of the jatropha plant can be processed into bio-diesel to provide light and cooking fuel for poor rural families. Japtropha has advantages over other bio fuels, such as maize and soya, as it can grow well on dry lands where food cannot grow and animals do not graze on it. In addition, seed cake, a by-product of the process, can be used as fertiliser and animal feed, according to the report.
Obama’s grandmother honoured in Kenya Cooking with paint tins and sawdust in Zambia A farming community in the Ndola district of Zambia has welcomed a new stove that could revolutionise the way they cook their food. The invention could also help save forests and reduce global warming. Made from a used 5-litre paint tin, the stove uses sawdust to cook and boil water. It sports a 4-centimentre hole drilled at the bottom and a pipe inserted in the middle which acts as a chimney. Once the stove is packed with bricks of compacted sawdust, it is lit using a piece of cloth dipped in kerosene. Farmers who have tried the stove say it is very efficient and, with free sawdust in abundant supply, a cheaper alternative to charcoal stoves.
She’s never been inside a lecture theatre and she doesn’t speak a work of English, but these are no handicaps for US President Barack Obama’s grandmother. The 87 year old was recently awarded an honorary Doctorate of Letters by the Great Lakes University of Kisumu in recognition of her charitable work. Mama Sarah Obama has been active in helping poor and sick people in Kenya and further afield. Last year she was given the honour of starting a local motor rally organised as part of World AIDS Day.
Be HIV free to wed in church in Bamenda, Malawi
Namibian girl premieres in lead film role A Namibian primary school girl has hit the silver screen as the lead female character in a new movie made by a Spanish film company. Eva Maureen Gerretsen beat stiff competition to win the role of Jana, a 10 year old girl who meets a young Bushman boy in the streets of Barcelona, Spain, and then embarks on an enchanted adventure to Africa. Accompanied by her magical winged horse, she sets out in search of the boy and becomes good friends with Mel, a Himba villager who guides her through encounters with magical beings and creatures. The film, ‘Magic Journey to Africa’, was screened for the first time in Spain at an event attended by Eva and her parents.
Catholic bishops in the Bamenda region of Malawi have announced that couples wanting to marry in church must produce an HIV test certificate before they can wed. The bishops say the requirement is part of the Catholic church’s efforts to control the spread of HIV in the region, which has one of the highest prevalence rates in sub-Saharan Africa. But the move has been criticised by some commentators, who argue that people living with HIV have just as much right to wed in church as everyone else.
A registered charity in England & Wales (no.288527) and in Scotland (no.SC039986). Funded by the Pan-London on HIV Prevention nt Proggramm ramme
A tre treatment that may stop HIV infection after the virus has entered the body. C Caution: It’s most likely to work if started within 24 hours, or at the latest within 72 hours. Tr Treatment lasts four weeks an and may cause side effects, w which can be treated.
PEP is not a substitute for condoms
For mor more information about PEP please vvisit www.tht.org.uk/pep or call THT Direct on 0845 1221 200