Health and Democracy: Africa's long journey to realistic development

For the past year, I have been working on the Aids billions that Malawi has recieved since 1992. The figure is astronomical and the impact can only be translated by those that are in offices unfortunately. I am amazed by statements such as 'we have made disignificant progress' in mitigating HIV and Aids in Malawi.
Whilst in Zambia, I found a centre where ARV access was 13 days away from the nearest village in the Western province, strange enough it meant this person who was already sick spent most of his time travelling to collect the essential drugs.
The total expenditure versus emoluments of people working in the sector, the consultancies and salaries are too huge for one to comprehend. For almost each 1 billion kwacha spent in Malawi only 5 percent or 10 percent reaches the real HIV positive person or those affected by it.
The full story wil be published very soon in my paper, once I get someone senior to comment on my findings. Unfortunately it has taken more than three months for that someone to comment since I sent written questionnaire.
But looking at some of the issues, like in Jali, Zomba, I found a community weary of Aids and Development projects. Most of them uncordinated and over 10 NGO's working in the area from AIDS to food security and Social Security.
Despite the new jargons of partcipatory approaches, community mobilisation and anything that has replaced community based planning and the like, the truth remains that after operating for more than 10 years now, people in the area are still poor and still sliding into poverty.
May be someone who taught me at Havard was right, be skeptical of statistics all the time.
Malawi, Zambia, Mozambique and many Southern African nations are still searching their foot to be called a fully fledged democracy.
The people in Jali actually are weary of the projects. At a meeting the Bingu Silver Grey Foundation conducted in 2007, there were indications that actually the projects were disturbing communities to carry out personal development activities.
Instead of engaging in their subsistence farming, they have to attend awareness programmes, home based care programmes and developmental meetings which will not have a direct bearing on their food and home needs.
Unfortunately the reduction in food has consequences in the long term health of the people who now have to shuttle between construction of school blocks, via a church meeting to a political campaign rally.
I was left speechless in Chipoka when a woman told me, "this democracy will kill me."
Has anybody tried to do research on the new found democracy and its impact on the health of the people? My guess and everyone is no.
Agencies have been over the years excited that Africa is opening up and though one of the most researched continents among the five, Africa remains the poorest and with no immediate hope for its challenges which includes Health, poverty and taming conflicts.
The global voices of conscious have decided to ignore Somalia because they think that is 'something you cannot solve'. There are stories of why Darfur problems cannot be solveD.
Partners in Health, working with the Clinton Foundation have built a healthy facility in one of Malawi's poorest districts of Neno. Ther local and foreign staff who have committed themselves to improving the health of the ordinary people in a poor setting. The impact is instant and the results are forthcoming.
May be the World needs Paul Farmers and Jim Kim type of thinking to solve the health challenges that it faces. After billions spent through some of the United Nations agencies, through International organisations seem to have failed to make a difference in the life of the many poor Africans.
Now how does poor health impact on Africa's democracy? Former President Thabo Mbeki seriously believed that HIV does not cause AIDS but poverty. When I travelled to Kwazulu Natal recently, a woman who had struggled to raise funds to feed her three Children, felt bad that a whole democratically elected President-then Mbeki- could think she would have AIDS from poverty.
"I have been poor all my life, but I am not sick. I have never had a rich family only the poor in my family, it is strange someone to think like that. It is this democracy that is bringing us crazy leaders," said the woman.
Ill health will undermine people's will to participate in anything, and that is no exception to democracy.
While the Western Governments and even other major agencies are investing in Human Rights, Governance and Democracry consolidation programmes, failing to link it with access to quality healthcare means achievements and gains made over the years can be eroded faster than any other programme in history.
People are more worried in Africa about their well being than demand accountable Governments as the case of Zimbabwe should have taught many. It is not a case of giving up but rather of priority setting. Only well fed and healthy people could sustain democratic nations.
Africa's biggest challenges is now to allow the majority of the people, who unfortunately are poor and rarely participate in formualtion of decisions affecting their daily livelihoods to have a healthy life and reduce the burden of the many diseases that affect them.
Poverty which causes poor health and poor health that leds to poverty needs to be placed on priority Governance issues alongside other human liberties if the continent is to move forward.
Exepecting the sick and malnurished people to demand an accountable President in Zimbabwe, Malawi, Zambia or South Africa is demanding a trip to mars in Africa.
Health and Democracy are very much related as only when people are healthy they will happily have time to vote, time to discuss political decisions and even critically design programmes in their communities holistically not to wear them out with too many demands for the same 24 hour period.
Further, lessons could be drawn from all high profile deaths in Africa including that of President Mwanawasa of Zambia, Kamuzu Banda of Malawi and seeking of treatment in foreign countries by current leaders including Nigerian President recent trip to Saudi Arabia that improving health and providing quality healthcare services is in the interest of those in Governance structures as well.
Without proper health care systems, Africa is still far away from attaining a proper democracy. This could be the next topic of the many funny researches that are taking place in Africa!!!


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