Child Saver

By Simon Robinson / Mbabane

Prejudice and stigma remain powerful barriers in Africa's fight against AIDS. Misinformation, bigotry and indifference can be found everywhere, from tiny villages to presidential offices. Nowhere is that more so than in Swaziland, a mountainous southern African country with the world's highest rate of HIV infection. An astonishing 42.6% of adult Swazis are HIV-positive. It doesn't help that Swaziland's ruler, King Mswati, 37, who is Africa's last absolute monarch, sets such a bad example. Mswati may advocate abstinence and faithfulness, but he hardly practices what he preaches. In September he chose his 13th wife, a 17-year-old girl he picked out at the country's annual reed dance festival.

Busi Bhembe, director of the Swaziland Infant Nutrition Action Network, is one Swazi who is trying to change people's attitudes toward AIDS. She leads a pilot program to help Swazis better understand how the disease affects pregnant women and babies. "The more mothers know about the virus and what it can do, the better they can take care of themselves," says Bhembe, 36, who trained in nutrition at the University of Swaziland in Mbabane before entering health management.

In some ways, the program--known as the Prevention of Mother-to-Child Transmission Plus Concept (PORECO)--looks like many such schemes around Africa. Besides educating mothers about the best way to breast-feed their kids, it gives newborn children a protective dose of nevirapine, an AIDS drug proved able to stop transmission of HIV through breast milk. The program, run in conjunction with the Swaziland Ministry of Health and funded by drug company Bristol-Myers Squibb, goes beyond the usual clinic visits. PORECO offers a large measure of community support and education, the kind of comprehensive care that Bhembe hopes will help slow the rate of infection in Swaziland.

The program is small--some 150 women have enrolled so far, and there are places for only 50 more. But teaching pregnant women about the need for good nutrition while carrying, and giving those with low viral counts antiretroviral drugs to make them healthier have produced encouraging results: only 8 of the 118 children born so far have tested HIV-positive, a sharp drop from the standard 30% to 40%.

Bhembe helped start the program after working with breast-feeding mothers, many of them HIV-positive, who were having problems feeding their children. "I would go home in the evening and look at my two healthy sons and count myself blessed," she says. "I just had to help these mothers." She takes a matter-of-fact approach toward HIV/AIDS that still surprises many Swazis. "I think what has worked for us is to have an attitude that it's not a special disease. We talk to a patient like you would if he or she had cancer or is diabetic," she says. "Once you introduce it like that, patients begin to say, 'Oh, yes, my mother is diabetic and takes medication to control it.'"