VSO(Voluntary Service Overseas) believes in sharing skills and experiences so as to change lives. As a VSO volunteer, permit me use this space to share my experience and knowledge on HIV/AIDS. As we all know, December 1st is designated globally as international AIDS Day. I want to congratulate Minister Ramsammy who said that Guyana is successfully moving towards this year’s AIDS Day theme- ‘GETTING TO ZERO’. What I want to remind everyone though is that HIV/AIDS is an epidemic which human race should not underestimate and think the battle is over or approaching its end. HIV has a potential to make a ‘tactical withdrawal’.
The perception that the war is finished is dead wrong. In Uganda, we thought the battle was almost finished given the successes made in the late 1980s and early 1990s in combating HIV. However, recent findings show that infection rates are again on the rise. Personally, I feel People might have celebrated the victory too early.
Notwithstanding other habitual causes of death like smoking and diet, HIV/AIDS is an epidemic which should not be taken lightly. According to UNAIDS, by mid 2000, 40 million people were estimated globally to be HIV infected and about 20 million people had been killed by the scourge leaving behind a whopping 15 million orphans.
Though in the Caribbean the epidemic has not caused grave impacts as it has done in sub-Saharan Africa, there is need to adopt a multifaceted approach if we are to successfully fight HIV/AIDS.
Other than relying much on the traditional ABC strategy, it is high time other strategies such as behavioural change are adopted. In Africa, HIV/AIDS has been able to spread fast not necessarily because people are sexually immoral but because of their cultural behaviours, beliefs, practices, ignorance and poverty.
For example, most traditional healers in sub-Saharan Africa believed HIV/ AIDS was an evil spirit which would suck people’s blood and hence, slim them away. This is why in Uganda, HIV/AIDS is referred to as slim or Mukenenya. Because of this belief, traditional healers contributed to HIV transmission because in an effort to guard people from this evil spirit; they were cutting people’s flesh to insert herbs using one razor blade. Unfortunately, one razor blade could be used to cut all the persons and at the end of the day whole family members would become infected. In this scenario, ABC strategy is very useless. This also affected tribes which practise circumcision.
The surgeon would use one knife on all candidates.
Other cultural practices like Inheritance of widows and polygamy have played a significant role in HIV/AIDS transmission in Africa.
Not many years ago, the former South African president Thabo Mbeki said that there is nothing like HIV/ AIDS but poverty. Many people scoffed at the guy’s idea but they just failed to understand the man’s point.
There is a strong correlation between poverty and HIV/ AIDS infection. It is said that SOWETO (South western town) in South Africa has had high rates of HIV infection because of low incomes.
While carrying out a research with an organization I once worked with, a prostitute frankly told me that she would rather sell her body, get HIV but live for 10 years than to
refuse to sell her body and die of hunger in less than three days. This may sound silly but the argument has a strong point. Though cultural practices such as inheritance of widows and allusion of HIV to evil spirits in the Caribbean are lacking, behaviours/ people’s lifestyles must be checked if the Caribbean region is to attain full victory over HIV/
AIDS. Behaviours such as drinking, partying, cross generation sex and multiple partners are very rampant and need to be addressed urgently. It is very difficult for a man, who
is intoxicated to abstain, be faithful let alone use a condom properly. Even those who are not driven by liquor, lifestyles like clubbing and cross generation sex (CGS) can expose them to HIV infections.
In order to outmatch the rate of HIV infections so as to “get to zero”, the Strategies to fighting this epidemic should be multi faceted like the epidemic itself. Policy makers should device strategies which demystify HIV since it (HIV) has greatly thrived on people’s ignorance, myth, and poverty and gender inequalities. Addressing these issues in
a broad based manner is very vital.
HIV related stigma could also undermine efforts to curb this enemy within the Caribbean. Due to societal support towards PLWHA (people living with HIV/AIDS) in Uganda helped us to fight this scourge. Many people started coming out openly and indeed, they were supported. For the two years I have been in Guyana for example, I have not yet read neither heard of any one who has openly come out to confess they are HIV positive. This unfortunately means stigmatization is common. Because of stigmatization, HIV infected persons are not willing to come out and it is possible for them to continue infecting others. Communication For Social Change (CFSC) is one of the approaches I would suggest. While working with disabled persons living with HIV/AIDS in Uganda, I used this approach and it bore results. This approach has also borne results in my work as a Special Education Needs specialist with the Department of Education, Region 1. I have used this approach because, like HIV/AIDS patients, persons with disabilities tend to be stigmatized by the community. The ideal of this approach is community dialogue and collective action through which the community herself identifies priorities, develops a vision and plan of action, and mobilizes internal and external resources to carry it out. We need to appreciate the fact that communities function to a certain extent like living organisms. Every time a living organism undergoes a certain process, it tends to change. Likewise, if a community takes on this process, changes such as increased knowledge and healthier behaviour at an individual level as well as strengthened community leadership, broader participation, and social cohesion at a community level can occur. At the level of service providers, a holistic approach which involves other stakeholders such as international and local non-governmental organizations should be adopted so that a consensus approach is developed in fighting this scourge. Failure to reach consensus may result in overlaps in messages and programmes. This may lead to the emergence of gaps. These gaps may be exploited by the epidemic to spread further. Also, the programmes, messages and media used should be relevant to the targeted group. In Uganda for example, the government encouraged the policy of “zero grazing” to encourage people to reduce their multiple partners.
To achieve this, the government relied much on faith based organizations. On cross generation sex (CGS) which has been common mainly among university girls, a national
sexual and reproductive health/ behaviour change programme to discourage the practice of “something for something love” (SFSL) was started. This is being achieved through a drama programme called 256 rock point and is aired on 14 radio stations in Uganda.
A multi-faceted approach …
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