Geography Reference
In-Depth Information
Box 39.3
The HIV/AIDS epidemic in Asia
Stanecki and Way (1997) suggest that the epidemic in
Asia is diverse. Rates of infection are very low in the
general population in countries such as Mongolia and
South Korea and as high as 2.1 per cent in Thailand. In
India, estimates of overall numbers infected are in the
range 9 to 10 million, but the distribution is uneven
between states and regions. In Mumbai, rates as high as
51 per cent have been recorded among commercial sex
workers, but similar rates have not been evident in Calcutta.
It is in the poorer countries of Southeast Asia that rates are
increasing most rapidly, in Burma, Cambodia and Vietnam.
However, in the largest countries of the region, India and
China, current knowledge about prevalence is poor and
there is probably a tendency to under-report the numbers
of cases of people who are sick with AIDS.
Box 39.4
World Bank: Household Impact of
adult death
The overall economic impact of adult death on the
surviving household members varies according to three
sets of characteristics:
That somebody has died of AIDS may have an effect
on each of these three sets of variables for the
following reasons: (1) AIDS deaths may take a long
time and the search for care may eat into household
resources; (2) given the sexual nature of
transmission, one death usually suggests the later
death of a spouse and thus leads to clustering of
deaths; (3) assets will be spent in care and treatment;
(4) AIDS is often stigmatising and therefore
community assistance may not be forthcoming or
community involvement may be rejected; (5) some
communities may be affected more than others and
therefore be less able to cope with the large numbers
of deaths and the extent of illness—a situation that
could arise in the case of some communities in
Ukraine— Box 39.5.
•
those of the deceased individual such as age, sex,
income and cause of death;
•
those of the household, such as composition and assets;
•
those of the community, such as attitudes towards
helping needy households and the availability of
resources.
The first set of characteristics determines the basic
impact of the death on the surviving household
members; the second and third influence how well the
afflicted household copes. Although disentangling the
three is very difficult, it is nonetheless important when
attempting to assess the household impact of an adult
death to consider all three factors.
(World Bank 1997: p. 209)
level, it may mean that there is a decline in the
production of cash crops or of cattle products as
labour for these tasks is insufficient or is diverted
into caring for the sick and other dependants (thus
having a major effect on the lives of women); at a
national level, the World Bank has estimated that
the epidemic is likely to decrease the rate at which
GDP increases and the rate of growth of
per capita
income—all against a background in many
countries where GDP and per
capita
income
growth is either very slow or, as is the case in most
of Africa and parts of the Former Soviet Union,
where these have been in decline for some years.
the effects on rich and poor alike in this most
seriously affected region of Africa (Barnett and
Blaikie 1994). More recent discussion of how
households cope with excess death and illness may
be found inWorld Bank (1997: pp. 206-63).
The first household had been comparatively
wealthy and coped by combining members of
other related households which were living
separately until they themselves began to
experience illness and death within their own
and related households as a result of the disease.
The man is very old (aged 78) and is
married. His wife is also elderly. They had ten
children, but a daughter and two sons have died
of AIDS. Until the disease struck, this couple
was living in an independent household,
farming and living off their assets with some
help from their son and his wife who lived
Households under stress in Uganda
The following accounts of how households in the
Rakai district of Uganda had been affected by
HIV/AIDS in the late 1980s dramatically illustrate
