Dangerous Bananas

Children are the wealth of the poor, say the fishermen of Angolares on the island of São Tomé. If a wife has not conceived after a year of marriage, the families take the couple to a traditional doctor for fertility treatment, and if this still does not work, the wife's parents arrange another husband. The pressure to have children is not exclusive to Angolares, some 35 kilometres south of the capital, São Tomé, it is equally strong in the rest of the country and one of the reasons for low condom use, according to Dr Antonio Amado Vaz, director of the São Tomése Association for Family Promotion (ASPF). "The first concern of a woman when she marries is to give her husband a son, and to prove her fertility," he told PlusNews. The two islands have a total of 160,000 people, but 50 percent are younger than 15 years and a further 20 percent are aged between 15 and 24, according to the 2004 HIV/AIDS National Strategic Plan. Another factor hampering the use of condoms is strong opposition by the Catholic church and other religions, together with cultural taboos that do not allow people to speak about sex, which "stifles the dialogue about AIDS" said Rosa Carvalho, a fish seller and a member of a youth movement against AIDS. A study conducted in 2004 by ASPF and an Italian NGO, ALISEI, showed that little more than a third of the men and women interviewed used condoms regularly, although men used them more frequently. The HIV/AIDS strategic plan attributes the negative attitudes towards condom use to social and cultural factors: men refuse because it reduces the pleasure - 'one should not eat a banana with its skin' is a popular saying; women fear the condom could damage them, reduce their worth and make them seem immoral. Young people know condoms protect them against HIV, but rarely use them because they do not recognise their vulnerability to infection. Eduardo Matos, the former Health Minister and a medical doctor, added that "traditional medicine is gaining more ground than the mass media" and eroding condom awareness campaigns. Condoms are distributed freely at government health centres, in discos, cyber cafes, schools and markets. Some private clinics sell them at a symbolic price of 2,000 dobras, the local currency (about two US cents). In 2005, the Health Ministry ordered 450,000 condoms from the United States, with funding by the World Bank. The campaign to promote condom use is on course, hoping to convince the São Tomése people that "eating unpeeled bananas" is safer.