Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
International Federation of Red Cross and Red Cresent Societies - 26 September 2003
Pekka Reinikainen in Nairobi
She says there are three major threats to success in HIV/AIDS work at community level in Africa: "We need to fight fear, finger-pointing and outdated traditions;" she says.
"We fear things we do not know. When we are afraid, we tend to try to protect ourselves by stigmatising the cause of our fear. Fear towards HIV/AIDS can be fought with increased knowledge. If we conquer fear, we will also cut the life-line of stigma," explains the Federation's senior HIV/AIDS officer, Selam Seje.
Of the three threats, ancient traditions may very well turn out to be the toughest nut to crack.
In certain African communities, old women pass on knowledge to young girls on how men are pleased in bed. These girls then get to put their new skills into practise when a man from the community visits them one night at the hut where they all sleep. If he is HIV-positive, he has multiplied the infection-rate in that particular generation overnight.
In other communities brothers "inherit" the wives of their deceased kin. Where once this ensured the social security of widows in tribal communities, today it can help propagate the HIV/AIDS virus.
"These are not the only traditions that are killing our people," Odhiambo says. "In many African communities it is considered acceptable, even desirable, for the male members to have multiple sexual relationships while married. When one participant of these lover pools gets infected, all will be exposed."
In scaling up its HIV/AIDS programmes in Africa, the Federation, through National Societies, is doing so in line with African Red Cross and Red Crescent Health Initiative (ARCHI 2010, the overarching principle of which is to mobilise the enormous and competent human resources that National Societies have available at community level.
"We are concentrating the bulk of our strength in our work within vulnerable communities," explains Eastern Africa health and care advisor Patrick Couteau.
Dorothy Odhiambo and Selam Seje agree: "Unless we can bring about a significant change in attitudes and behaviour at the community level, we will never succeed in curbing the pandemic."
Meticulous work with ordinary people in the midst of poverty, food insecurity, bad infrastructure and non-existent public health services will not make headlines in the media. "We are not scaling up to please the press," Couteau points out. "Our aim is to have an effect on individuals. Through them we will change their communities and eventually nations."
"The results of our work will be visible even if media does not have time to be there and watch this seed germinate and grow," he says.
Red Cross Red Crescent will scale up its HIV/AIDS work in Africa both qualitatively as well as quantitatively. "We will not sacrifice the standards of our services in any numbers games. We scale up the scope of our activities by consolidating what we are already doing to ensure that we do it even better in the future," Couteau pledges.
In addition to fighting stigma and discrimination, Federation is gearing up its prevention activities. "These two are actually interlocked. Increasing knowledge and reducing stigma have a preventive effect. We are specifically targeting two groups in communities: community leaders as decision makers and youth," Selam Seje says.
She says leaders are targeted because they are the gatekeepers of their communities. "If they lead through example, others will follow. Youth is a target because if they are saved, so is the future."
"We need prevention programmes planned by youth and executed by youth for youth. There is no real alternative to this," Patrick emphasises.
The third target for scaling up is community- and home-based care and treatment. "Here, too, we need increased involvement of people living with HIV and AIDS (PLWHA). We do not wish to see PLWHA as mere targets to our care and treatment activities. The International Federation wants to empower PLWHA to take the lead eventually in all matters related to HIV/AIDS issues," says Dorothy Odhiambo, who is HIV-positive herself.
13th International Conference on AIDS and Sexually Transmitted Infections in Africa (ICASA) had its closing ceremonies today, Friday 26 September 2003, in Nairobi, Kenya.
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