Zambia: Hope in the AIDS epicentre

Three drummers signal the start of the performance. "Now we have come to teach you about HIV/AIDS. Woza! [Come!]" they sing. A teenage boy and girl sprint out and dance amid the swelling circle of young onlookers. The rapt audience roars with laughter as the dancers give way to a young man dressed in big red shoes, overalls and a funny hat. He is playing the part of a father who is scolding his teenage daughter, "You mustn't go out with so many men!"

After the performance, audience members crowd around the truck asking for information about AIDS and for condoms. "We are making a difference," asserts Levy Kafuti, the 23-year-old coordinator of the troupe. "More people come to our performances every time. By the time kids reach puberty, they will know exactly how to protect themselves. It gives us much hope."

The Anti-AIDS Club of Chibolya, formed in 1995, is one of 1,760 such clubs in Zambia spreading AIDS-prevention messages through a variety of activities. The Chibolya Club's boys' soccer team and girls' netball team, for instance, deliver HIV/AIDS-awareness messages at their games. Performances of the 10-member drama troupe are staged in conjunction with visits of the Family Health Trust 'AIDSmobile', which distributes free condoms, advice and literature.

(Adapted from the State of the World’s Children 2000, UNICEF)

 

Throughout the world there are examples of courage and strength in fighting the AIDS epidemic. Below are a few of these.

An outstanding example is the peer education program of the Mathare Youth Sports Association in Kenya, an organization run by and for young people. The majority of its several hundred volunteer staff are under the age of 16. These trained volunteers carry out HIV prevention fieldwork within the community through small group discussions and workshops during sports activities at weekends. Every year, 50 new peer educators are trained to deliver this programme to some 8,500 adolescents between 12 and 20 years of age who participate in their weekly football and other sports activities. Since 1987, the programme has reached over 30,000 young people. UWESO (Uganda Women’s Effort to Save Orphans) originally started to help children orphaned by war, and changed its focus in response to the AIDS crisis. UWESO funds education and training for AIDS orphans, and gives small loans to help their caretakers start up small businesses and trading activities The World Association for Girl Guides and Girl Scouts combined an AIDS peer education programme through the Association’s regular badge system. Their badges carry a red ribbon which can be earned by their membership after demonstrating and disseminating prevention messages among peers or being involved in care and support activities for their members who are living with HIV. AIDS Hotline and Counselling Service in Egypt is a telephone counselling service that gives people a chance to talk about sex and sexuality in a society where it is culturally taboo to do so. The anonymity encourages people to call, and the Hotline receives over 1000 calls each month, much more than originally anticipated. In Zambia, a group of NGOs collaborated with the Ministry of Health, the district council and young people themselves to make their health services more youth-friendly. They trained 52 young people over a period of two weeks to provide counseling on pregnancy, sexually transmitted infections, substance abuse, financial concerns, and communication with sex partners. Side by side with the medical staff in the primary health care clinics, these peer counselors act as the link between their peers and the medical staff, attending to their special needs and assisting them to deal with the intricacies of a public health system. The results have been a remarkable increase in the attendance of young people in these services and the stronger intergenerational relationships within the community. The Maiti Project in Nepal rescues children and young women from traffickers. Instead of being sold into prostitution, the girls are given vocational training, support and counselling. As a result of Maiti’s work, 105 child traffickers have been imprisoned. The National Union of Eritrea Youth and Students has also set up youth-friendly health and recreation centres, where young volunteers provide peer education and outreach activities that include reproductive health, STD/AIDS prevention, and counselling for out-of-school youth.

A battle far from over

Although there are success stories, the fight against HIV is far from won. In 1999 alone, 5.4 million people were infected. There are still several areas where more intense actions have been taken.

Orphans: AIDS left behind 13.2 million orphans – children who, before the age of 15, lost either their mother or both parents to AIDS. These children face malnourishment, leave school to earn a living or care for younger siblings, face illness, abuse and sexual exploitation because they are no longer protected by their parents. Families who take in orphans often have insufficient resources to feed the children and to pay for their schooling. Orphans need help supporting themselves and their siblings without having to turn to the streets or orphanages that reduce their chances of health and safety. Girls: Infection rates are over five times higher in teenage girls than in teenage boys in Sub-Saharan Africa. These numbers show sexual mixing between generations: in rural areas of the United Republic of Tanzania, some 17 per cent of married teenagers reported having had sex with a man at least 10 years older than themselves. Interventions is needed to help girls avoid sex with older men, help them pay for school so that they do not need older men to do it for them, and condemn men who choose young sex partners. Drug users: Thinking that HIV can be contained within drug using populations has proven wrong because drug users have sex with non-drug users and spread HIV to the general population. It is common for injecting drug users to sell sex to pay for drugs, thus, the prospect of sexual transmission is highly probable. Comprehensive HIV prevention programmes that include AIDS education, condom promotion, needle exchange and drug treatment have shown to help reduce the high risk of new infections both in developed countries, such as the United States, and in newly emerging market economies, such as Belarus. Education: In the hardest hit countries of Africa, a great number of schools have shut down because too many teachers have died of AIDS. In addition, many students have dropped out of schools due to lack of resources to pay for educational expenses and to the need to care for sick members of their families. The education sector, which is counted on by society to help nurture young people and enable them to have jobs in the future, is jeopardized. Moreover, the potentially powerful role of schools, as a channel of the life skills education needed for AIDS prevention and care, is lost. Sexual and reproductive health education and services: Education and information are fundamental human rights. When people, especially children and adolescents, are denied the basic information, education and skills to deal with HIV – whether because of religious values, or socio-cultural preferences -- they are less able to reduce their own risk of infection. They are also deprived of the knowledge of health services where they can access information and assistance for health problems, both for problems commonly met by young people, such as unwanted pregnancy and drug use, and for prevention of HIV and sexually transmitted infections. Access to drugs: Ninety per cent of the people living with HIV have no access to drugs that help to combat the virus or its associated diseases. Reducing the price of drugs through negotiations with patent holding drug companies or producing generic forms of the drugs will make them affordable to people in the developing world. The health sector must be strengthened. Clinics and hospitals must be well equipped with staff and medication, so that they can treat diseases common to people with HIV, such as tuberculosis. Economic impact: AIDS is not only a medical issue. The economic impact of the disease is reflected in the highly –affected communities, where labour force is reduced and family structure is dismantled. Providing loans or grants to families caring for people living with HIV and to AIDS orphans may help families remove themselves from extreme poverty, which has increased vulnerability to HIV infection. Reduction of stigma and discrimination: In 1998, on World AIDS Day, a young South African woman told her community about her HIV infection. Several days later she was stoned to death. Her story is not an isolated incident as people with HIV are regularly turned away by health care providers, denied jobs and housing, refused insurance and entry to foreign countries, thrown out by their spouse or family, and even murdered. Protection of the rights of people living with AIDS is necessary for people to feel safe, whether they are working to prevent the disease or struggling to live with it.

Setting goals: taking action

Secretary-General Kofi Annan, in his Millennium Report presented for consideration at the Millennium Summit of the United Nations (6-8 September 2000), has proposed a series of actions the Governments should take to contain and reduce the spread of HIV/AIDS by 2015, including:

Adopt as an explicit goal the reduction of HIV infection rates in persons 15 to 24 years of age – by 25 per cent within the most affected countries before the year 2005, and by 25 per cent globally before 2010. Set explicit prevention targets: by 2005 at least 90 percent, and by 2010 at least 95 percent, of young men and women must have access to the HIV-preventive information and services. Have in every seriously affected country a national plan of action in place within one year of the Summit.