The right to life

By Nobukhosi Ngwenya

An article published a few months ago outlined how an organisation called Project Prevention was gearing to set up shop in South Africa. The project pays drug addicts and alcoholics to get sterilised. Barbara Harris, Project Prevention founder, would use the phrase “long-term birth control” instead of “sterilisation”. Let us call a spade a spade.

Already in operation in Kenya, Project Prevention has extended its “services” to HIV-positive individuals. Individuals are paid approximately $7 to get sterilised. I will not even go into that. Yes, it is of concern to me but I believe there are a couple of more pressing concerns raised by Project Prevention’s activities.

Firstly, can we lump HIV-positive individuals into the same bracket as drug addicts and alcoholics? For years now, the department of health and various other health organisations have been at great pains to decrease the stigmatisation of HIV-positive individuals. By lumping HIV-positive individuals in the same category as drug addicts and alcoholics are we not fuelling discrimination against HIV-positive individuals? Conversely, do we not risk returning to earlier days when it was thought that HIV is a virus that infected only drug addicts (and homosexuals)?

Secondly, who has the right to have children? I need to point out that I am not asking who is or can be a fit parent. That question would have to be addressed on its own.

What I am asking is: can we deny drug addicts, HIV-positive individuals and alcoholics their rights to have children?

HIV-positive individuals, women in particular, are being denied their rights to have children. This denial of their rights is less apparent than Project Prevention’s actions. The denial of HIV-positive women’s rights to have children occurs at service level. I believe that the separation of HIV services and reproductive health services, particularly in the poorest communities, amounts to a denial of women’s rights to have children. If we are genuinely concerned about the health of HIV-positive individuals and that of their children, surely the solution is to extend prevention of mother-to-child transmission programmes and HIV healthcare services.

Information dissemination alone is not enough. The early days of the HIV and Aids pandemic proved this. In South Africa, this problem is exacerbated by the fact that the necessary supportive infrastructure is unavailable. It is therefore imperative that prevention of mother-to-child transmission (PMTCT) service coverage be extended.

First, in high-density and/or remote areas, more antenatal facilities need to be established. It is ridiculous to expect a heavily pregnant woman or new mum to walk to the antenatal clinic, then to the clinic to get antiretrovirals and then back home. Never mind the long waiting periods in public clinics and hospitals. Furthermore, there is not enough (professional) support for HIV-positive women during their pregnancy and after they give birth. That is why PMTCT services need to be extended, more comprehensive HIV/Aids treatment and care for pregnant women, mothers and children under the age of five years. Let us do it for the children and their mothers.

And since we are genuinely concerned about the children, we need to begin the arduous task of improving the child grant and foster care systems. A distinction needs to be made between “children in need of care” and “children in need of money”.

Children in need of care, are orphans residing in child-headed households and those who are out on the streets with no adult to look after them. Children in need of money are orphans who have been “informally” adopted by relatives. It is important to note that these children may also experience economic hardships. But the grants system is designed in a manner that prevents “non-legal” foster parents from gaining financial assistance in the form of grants. So the grants system must be changed to ensure that it recognises the informal fostering system within black and many other communities. The foster system must also be changed to ensure that guardians are quickly awarded legal custody of the children. Such a change to the foster system would facilitate access to child-care grants for these children. In turn the suffering of the children would be lessened.

Will these solutions work? We can only hope. One thing I am almost certain of is that it will beat denying HIV-positive individuals their rights to have children.

Nobukhosi Ngwenya is currently completing her MPhil in development studies at the University of Cape Town. She is an entrepreneur and the co-founder of an NGO — The Schoolbag South Africa.