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 - 6 November 2003
Pekka Reinikainen in Nairobi
When Mildred Macharia, an Ambassador of Hope from the Network of African People Living with HIV/AIDS (NAP+) told her audience that she was that person and HIV positive for the past ten years, they told her that she could not be.
"Nobody said it straight, but I did not appear sick enough to match their image of what an HIV-positive person should look like," she says.
Mildred's audience was not just any crowd. They were employees at the headquarters of the Sudanese Red Crescent Society (SRCS) attending awareness training facilitated by the Ambassadors of Hope. After getting over the initial shock, they were full of questions. For almost everyone present, Mildred was the first HIV positive person they had ever knowingly laid eyes on.
Because of deep rooted fear and stigma, Sudan is not an easy place to live should you - like an estimated half a million Sudanese out of a total of 33 million - become HIV positive.
At the Central Hospital in Khartoum, HIV-positive people who need treatment are placed in an isolation ward. "The staff let you go to the door to take a quick peek through the glass at the HIV positive people. It is forbidden to enter because they say you are at risk of being infected," Mildred explains.
For a week in September, Mildred was on an Ambassador of Hope mission in Sudan with Dorothy Odhiambo, senior HIV/AIDS partnership officer at the International Federation's Nairobi regional delegation. They were there to assist the Sudanese Red Crescent to review a five-year HIV/AIDS strategic plan developed by a consultant and supported by the International Federation.
"Red Cross and Red Crescent National Societies reflect the nations they serve," Odhiambo says. "In the case of Sudan, we should not wonder about the initial low level of HIV/AIDS knowledge of the people working for the organization. Instead, we should take positive notice of the bold determination of the leadership of the Sudanese Red Crescent to tackle the issue head on."
Another important aspect to the mission was to stress the importance of the partnership between the International Federation and NAP+. Mildred and Dorothy were in Khartoum to empower the few HIV/AIDS activists that can be found in the country.
T here are fewer than 10 people who have publicly admitted being HIV-positive in Sudan. Stigma is still so great that it prevents people from not only being open about their status, but also from establishing what it is.
"There is no need to shout your status from the top of a mountain. But there are people in Khartoum and in the city of Juba already preparing the birth of an independent people living with HIIV/AIDS organization," the two ambassadors confirm.
They had a three-day programme with 13 HIV positive people from Khartoum, Juba and the South of Sudan. "At this stage of development, this is mostly about empowering Sudanese people living with HIIV/AIDS. We start from the very beginning. They need to re-establish their value as human beings and learn how to speak for themselves, how to encourage others. Lots of skills building."
Together with the participants, the ambassadors established a list of the most urgent issues that the fledgling people living with HIIV/AIDS organization will have to advocate on.
Top of the list is the closure of the HIV isolation ward in the Central Hospital because it epitomizes the ignorance and stigma surrounding HIV/AIDS. Other priorities include a rapid increase in testing outside the cities of Khartoum and Juba and increased access to drugs, including anti-retroviral medicine.
The concept of Ambassadors of Hope was created by NAP+ six years ago. To date, some 70 ambassadors have been trained, half of them - Mildred and Dorothy included - in 1998 in Lusaka, and the rest in Pretoria in September 2002.
"The idea is the same as with ambassadors of countries. We are ambassadors of people living with HIIV/AIDS, influencing our environment on behalf of our "employers", advocating for our agenda and helping governments, non-governmental organizations (NGOs) and other stakeholders to understand the immense value of participation by people living with HIIV/AIDS," Mildred says.
The bulk of the work done by the ambassadors is in their own countries, visiting provinces where activities by people living with HIIV/AIDS are low but prevalence rates are high and influencing organizations and government agencies.
"Since the start of the programme, we have had 20 international missions to 23 countries in Africa. Sometimes we go on our own initiative, sometimes an NGO invites us, sometimes we reply to a request from the government of that country," Dorothy explains.
Ambassadors can act in different roles during these missions. They may be gathering information about government policies or identifying HIV-positive people willing to become active advocates. A mission may concentrate on a specific task or issue, such as lobbying for an increase in testing facilities, or it can also take on a diplomatic character to influence the political leadership.
"Sudan will need our support and advocacy for a considerable time to come. Sudanese people living with HIIV/AIDS are starting to speak out, but the voice is still very weak and fragile. The partnership with the Sudanese Red Crescent is very valuable for the future. It is obvious that the Sudanese government listens to the Red Crescent when it comes to defining its HIV/AIDS policy. Together with the Red Crescent, Sudanese people living with HIIV/AIDS will have a direct link to this development," Dorothy emphasises.
Mildred Macharia is a trained lawyer, a member of the NAP+ and a HIV/AIDS activist since 1993. "I came out early with my status because I wanted people to understand that the virus affects ordinary people too," she points out.
Dorothy Odhiambo, a teacher by profession, divides her time between acting as an advisor to NAP+ and her work for the International Federation. HIV-positive since 1989, she is widely respected as one of the trailblazers of African HIV/AIDS activism.
During her recent trip to Sudan, Mildred Macharia challenged the preconceived idea of what an HIV-positive person should look like. "Nobody said it directly, but I did not look sick enough" she says
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