Expand the infrastructure, and you will also create the conditions in which HIV is sure to spread. This is one of the many dilemmas facing poor African nations.
An HIV/AIDS prevention programme is therefore connected to a project overseen by COWI to construct a bridge across the Limpopo River in the provincial town of Chokwe.
"Road and bridge construction projects typically take place in poor areas. The workers live in camps and are easy targets for prostitutes. Once the project has been completed, they move on somewhere else and the disease spreads," says Niels Mølgaard, COWI's supervisor in charge of the construction project.
A health clinic is attached to the bridge construction project, and it is here that Agostinho Simbine, leader of the prevention programme, attempts to educate the 250 workers about the risk of infection.
He does so using information material, workshops, plays and short films followed by discussions. Free condoms are also available at the construction site and in the camp.
The danger of infection is high. In Chokwe, the percentage of those infected with HIV is significantly higher than the national average. The area has traditionally supplied workers to the South African mining industry, and many bring the disease back with them on their return.
"Our greatest problem here is that nobody wants to talk about AIDS. Large numbers are dying, but no-one asks why," explains Agostinho Simbine. He works for an organisation called Verde Azul which runs the prevention programme.
The project offers a free, weekly anonymous test to workers and their families. Every week, new cases appear. As part of the project, advice and assistance is also offered to those who are infected but the programme seems to have hit a wall. "Not a single one of the 40 infected individuals that we know for a fact are working on the project at the moment have contacted us. They're afraid of being discriminated against and labelled as someone who lives a bad life. But without advice and treatment, they won't survive more than two or three years," says Agostinho Simbine.
The project cannot offer the life-prolonging antiretroviral drug therapy, but it can refer people to the local hospital, for instance, where treatment is available.
At Mozambique's national road authority, Administracao Nacional de Estradas (ANE), there is no doubt that their efforts are paying off despite the difficulties encountered along the way.
"The greatest problem, in reality, is the situation that arises once the projects have been completed. As we are donor-financed, any prevention work comes to an end at this stage. But we know that once a new road has been built, the number of infected individuals rises because the road brings more people to the area as well as large numbers who are just travelling through," says Miguel Angelo Mangue, leader of ANE's AIDS unit. By: Janne Toft Jensen, jaje@cowi.dk Published: 29.10.2007
The new bridge across the Limpopo between Chokwe and Guija will be approximately 500 metres long and is due to be completed on schedule in November 2007. The bridge is financed by the Nordic Development Fund (NDF), which has provided a loan that covers the bridge, an approach road and the road authority's programme for the prevention of the spread of HIV/AIDS.
The aim of the bridge is to generate more economic activity north of the river, an area which is currently poor and underdeveloped. A primitive road bridge once stood in the same spot, but Chokwe was badly hit by the massive flooding in Mozambique in 2000, and the bridge has not been reconstructed since. Today, goods and people are taken across in rowing boats. Crossing the river by car means a detour of a couple of hours.
COWI, which heads a joint venture that includes Swedish firm HIFAB International, is in charge of the project. The bridge is being constructed by Teixeira Duarte, a Portuguese contractor.