Challenges to HIV and AIDS Prevention. 3/11

We need to look at some of the initial mistakes in the early sensitizations on HIV and AIDS in the late eighties and nineties.

AfriComNet

By S. Beny Sam
March 2011

In the 70s and the 80s some of us had so much admiration for some of the countries in the Eastern and Southern Africa mainly for what we referred to as political maturity and general development. We saw them then as great producers of great politicians and academics.

Well, that was then…things have changed so much over the years that we are at a loss as to whether the whole continent was not on the verge of collectively going to the dogs.
In the early 90s, if you went to a place like Nairobi. If you were blindfolded in the airplane and placed in the center of that city and your blindfold removed, you will swear by your poor mother’s breast that you were in a Western city. You see Kenya had all one could admire.

Yes the structures could still be there, but that political mess in 2007 happened to have changed a whole lot of things. In Uganda, in the early 90s, it dawned on one that that country was carved out as an HIV zone. But you see although you could say that the people in the rural areas were kind of backward, the sensitization on HIV and AIDS sank into everyone and they were all alert and ready to fight it how admirable! In fact at the time Ugandans were overcareful not to help spread the virus. They served every drink, even beer and stout with straws and you opened your own drink, so that the bar tender does not touch your drink. They were so afraid of HIV and AIDS that they had all sorts of wrong notions as to how to contract it.
You could literally see small kids along the streets of their towns encouraging visitors or foreigners to have condom. They used to call HIV Slim. When you entered your hotel room, you will find condoms all over the place, so much so that you seem compelled to use them if you had to tangle. There will be condoms on the study table, under your pillows, in the wardrobe, in the bathroom and on the wall by the bed. Today Uganda is indeed a success story when it comes to political and citizen will to consciously fight the epidemic. So much for Uganda and their AIDS fight.

A couple of days ago I was listening to DJ Base Nightline which featured some discussion on HIV and AIDS and it was so amazing how little people still knew about the pandemic from the questions or comments they raised. But really what got me mad was a BBC interview last week where some youths said they wash and reuse the condoms because of scarcity. Others even said that they use plastic bags as improvisation for condoms. These were Kenyan youths, can you imagine! The fact that the youth have good intensions to protect themselves could be excused, but definitely, wrapping plastic bag round your penis and tie it up at the balls is incredible in 21st century Africa. Do you see why it is good to be small? Kenya is too big for authorities to get condoms to every nook and cranny.

Over here in Sierra Leone, I think we have enough condoms for those who care to use it. Aren’t we so blessed….tell me aren’t we? In the Nightline program on SLBC I mentioned earlier there were some of our compatriots who are still at the denial state. They claimed not to have seen anybody living with AIDS. For them it does not exist! Even when somebody living with AIDS called and spoke on the program, some people still had their doubts. Well one cannot be surprised since these days there are a lot of doubting Thomas’s in our country. I really loved the high knowledge level of the panelists on that program. One important issue is the distinction between HIV and AIDS. At first the two were separated by a slash, thereby giving the erroneous idea that they were one and the same. No…HIV is the virus and AIDS is the disease.

We need to look at some of the initial mistakes in the early sensitizations on HIV and AIDS in the late eighties and nineties. One major blunder was the scare messages that proved counter productive. In these days people will tell you that the moment you contract AIDS you will die, since there was no cure. The disease was thus synonymous with death. This to a large extent scared people to the extent that they did not see the need to even bother about attempting to protect themselves. Most of them gave up to fatalism and then started the campaign that in fact it did not exist.

Of course a big blunder initially was the efforts to trace the origins of the disease. People in the early periods spent so much time on tracing the history and played the blame game. All the talk of Green monkeys and all that only succeeded in distracting from the real issues at stake. Of course these could be part of the people living in denial that AIDS does not exist. What is still a problem is getting the right messages across. Most of the recorded songs on HIV and AIDS still have scare messages that are quite alarmist. Today messages should actually stress the fact that with the use of antiretroviral drugs, people living with the disease can live several years thereafter. One good slogan is There is life after AIDS. You do not give up on life simply because you have tested positive. You can actually continue living.

What is critical is that the drugs cannot be taken on empty stomach. So the issue of nutrition comes in. There is some irony about the challenges faced by those working on HIV and AIDS programs. Formerly a lot of people opted not to cooperate with agencies because they said they did not know people suffering from AIDS. Many agencies threw the challenge that if people living with the disease declare their status openly, they will be supported. This happened after 2003 when a national organization was launched in Freetown called Network of HIV Infected Persons (NETHIPS). Thereafter many other networks were formed at Regional and District Levels. This has really helped the Advocacy work since the people who were living with the disease are part of the campaign. A major shortfall however in some cases has been the area of care and support for those who have come out in the open to say they are positive. Care and support has been lagging behind the demands. The main reason has been that a lot of agencies had been working on the preventive aspect and not the care and support.

This development that is people coming into the open to say they are living with HIV and AIDS has helped a little bit to reduce stigma and discrimination. With the antiretroviral drugs, people living with HIV and AIDS look good and much confident in life. This is not to say that still some portion of our society still stigmatize and discriminate. See, like people say we are all vulnerable to diseases and it makes sense if we support those who are infected. You may not be infected but surely you can be affected

There are the poverty and development angles of the effects of HIV and AIDS. Since the disease reduces people’s ability to exhibit their potentials to the fullest, it undermines the community’s development and consequently makes people less able to reduce poverty.

Now we have other challenges. I must hasten to say that we should not exclusively concentrate on taking care of the sexual causes and forget the other seemingly silent and invisible causes. You can use condoms for sex, but what happens in the beauty salon? Many do not wear gloves and use razor blades one per person. With the skin head so much in vogue today, vulnerability is increased.

One other critical area is the transfusion of tested blood. We all know many Districts do not have the facility of blood banks and this leaves a dilemma of whether to transfuse untested blood just to save a life. Isn’t this a difficult situation? Do you start to see that there is more to it than the sensitization? Of course in scenes of accidents, first aiders without gloves may be at risk. As they say, better to have a wise enemy than a foolish friend. The good thing is that the test for HIV is free. And do not tell me you do not know where to get your free condoms. There is this argument that it is better to strengthen the fight against malaria since HIV and AIDS has had so much attention. Well I think Malaria is easier to prevent, since its mode of transmission is one and can be easier tackled. In any case HIV and AIDS aggravate other illnesses.

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