| Tools for fighting HIV and AIDS stigma in Northern Uganda |
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Lessons from Africa... By Marie-Luise Ermisch
While it is slowly recovering from years of instability caused by rebel insurgency, there remains a high HIV/AIDS prevalence rate of 8.2% among Northern Uganda’s adult population, as compared to the national rate of 6.4%. Poverty and prolonged insurgency has led to the degeneration of cultural values, making the population of Gulu extremely vulnerable to HIV/AIDS. High unemployment rates have also forced many to turn to commercial sex for income which, when coupled with the constant population movement common to the area, puts many people at risk. Other factors contributing to high prevalence are child defilement, gender-based violence, stigma, self-denial, and mother to child transmission. With so many factors feeding into the problem, only a multifaceted solution could have an impact. EWA, a national non-governmental organization (NGO), sought such a solution through information, education and communication (IEC). The proposed solution was three-fold: 1) HIV/AIDS awareness campaigns through radio programs, IEC material dissemination, and public dance/drama performances. 2) Training and advocacy for people living with HIV/AIDS (PHAs). 3) Radio programs focusing on reducing stigmatization. Through these activities EWA hoped to encourage PHAs to adopt and maintain positive living practices, increase the disclosure of HIV status among sexual partners and improve community involvement in HIV/AIDS services. Through WACC funding, the project became a reality and 2008 saw many positive achievements, challenges and lessons learned. When implementing any project at the grassroots level, an NGO must always form good relationships with local leaders and other NGOs active in the area. To this end EWA organized a consultative forum in which to discuss project strategies to avoid the duplication of services and hear recommendations for how to best implement project activities. Not only were new ideas gained but other NGOs saw the need to increase their activities in relation to HIV/AIDS and good working relationships were established with local leaders, whose support became invaluable to the project. Soon after, HIV/AIDS sensitization was carried out through drama and music sessions – over ten sessions were conducted in four divisions of Gulu Municipality, reaching over 2000 people. These sessions aimed to increase HIV/AIDS awareness by highlighting issues surrounding stigma, the care and support for HIV/AIDS patients and the community role in HIV/AIDS prevention. Such performances were effective live performances have strong impacts. One indicator of this, for example, is that the Municipal HIV/AIDS Focal Point Officer received over 35 referral cases for integrated HIV/AIDS support through advocacy following the drama sessions. In order to reach an even wider audience, EWA also used radio messages focusing on stigma and the care and support of PHAs. Over a period of seven days, two spot messages were run three times a day on Mega FM, one of Gulu’s radio stations. In total, six radio programs were conducted on Mega FM in 2008, reaching out to the populations of over five districts within Northern Uganda. These programs proved to be effective as people called in during the programs for more information and wrote letters and/or visited the local EWA office to request more information, posters and brochures. A solution to the problem, however, is only possible when also specifically targeting and utilizing PHAs. Thus 328 PHAs were trained in positive living, positive prevention, drug adherence, reduced stigma and orphans/vulnerable children childcare. Of those trained, over 246 have now openly declared their HIV/AIDS status and some have even created drama groups in order to share their testimonies with others. Live testimonies coupled with drama presentations will become a powerful tool in the next phase of awareness campaigns for reduced stigma, safer sex practices and positive. While the response to the training was encouraging, one must not forget that PHAs are often poor, weak and in need of care and support. In fulfilling its mission of empowering the vulnerable and providing them with increased self-esteem through sustainable development, EWA was able to solicit additional funding in order to provide two sewing machines and two carpentry kits to selected groups of PHAs. These income generating tools have provided the recipients with new confidence and a way of providing for their families. The PHA group that received the two sewing machines, for example, has opened a tailoring shop and is now filled with hope for the future. Despite these successes, many challenges were faced. Most importantly, it was noted that NGOs often prefer to work in rural areas, leading to the neglect of the urban poor. Many people in Northern Uganda have been displaced due to the insurgency and have come to cities looking for work, making this a crucial service gap. Also, facing high population and poverty levels made it impossible for EWA to complete its strategic awareness campaign within one year. EWA also observed that more women than men attend sensitization meetings. It seems that men, due to their dominant social status within the culture and communities, fear to disclose their HIV/AIDS status. Lastly, a large percentage of the target population does not listen to the radio, rendering radio communication ineffective when considering the very poor. Many lessons were learned during this project. First, drama presentations are the most effective communication tool in HIV/AIDS sensitization. Drama presentations leave deep impressions on the minds of the audience, as drama is difficult to forget. Second, sensitization is not only important in combating ignorance on HIV/AIDS and stigma, but also in providing PHAs with the confidence to openly disclose their status. Third, local officials are integral to project implementation. Partnering with local leaders builds confidence within the community and allows for the sustainability of the program. Lessons for future projects were also learned. Mass communication is effective, but organizations should also visit the homes of PHAs to build relationships with them, encourage them and demonstrate that they are important community members. The confidence thus acquired will encourage PHAs to live positively. For more effective program execution, especially at the district level, the working relationship between local and municipal leaders needs to be strengthened. Also, HIV/AIDS prevention needs to start at a young age and therefore drama presentations should also target schools and tertiary institutions, creating a broader base of awareness. Lastly, the capacity of local volunteers needs to be increased so they can spearhead community-based communication for HIV/AIDS, positive prevention, reduced stigma and positive living, thus increasing project sustainability. Communication is an important tool in combating HIV/AIDS. When adapted to local contexts and needs, it can indeed make a difference and save lives. Add this page to your favorite Social Bookmarking websites         
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