HIV/AIDS - The dilemma of the inevitable

I officially became an African when l visited Nigeria two weeks ago, so I was told. No one is ever considered one until you make this pilgrimage and you have to go there to understand what they mean. So it is in this same spirit that I defend Nigerians, although l never thought that it would ever come to this. The most shocking discovery was that it is the Nigerians who leave the country to pursue greener pastures that give it a bad name with their survival antics. Nigerians on the whole are actually very honest people, with a few rough edges, but honest and very hospitable people. Hard to believe if you have met and dealt with their representatives on the continent.

All this l discovered after chain locking my suitcases with all forms of intricate locks that it would have needed a seminar to unlock. As l tightly clutched my limited hand luggage whilst checking in at the airport l was taken aback by the politeness yet in your face approach. But l was certain l was not going to fall for the famous sleek tongues they use to ensnare their victims…l knew them! I had read up on them! Be aware and be very afraid! But you can only go on for so long until you make up your mind to remember to relax as long as you have your passport and return ticket, which I had to check on so very often to ensure that it was still there. I had spent the better part of the earlier days going through a morning ritual of leaving my room with everything secured back into its cases. But to be honest l came back with everything l was supposed to come back with and very safe and sane and with a deep respect for a people who are unique in their own right, very unique.

But this is not about extolling the virtues of Nigerians but a gaining of an in depth understanding of the impact of HIV/AIDS on this nation and how people relate it to their daily life. To date Africa is the region worst affected by HIV/AIDS, with 70% of the world’s 42 million infected people (29.4 million people).An estimated 25 million people are living with HIV in sub-Saharan Africa, despite the apparent stabilization in HIV prevalence rates, with a yearly infection rate of 3.2 million Africans – 8,700 Africans every minute! This means that it will take 250 years to wipe out 10% of the world’s population and the “dark continent” will be riddled with bush and veld! Breaking it down further in southern Africa all seven countries have prevalence rates above 17% with Botswana and Swaziland having prevalence above 35%. In West Africa, HIV prevalence is much lower with no country having prevalence above 10% and most having prevalence between 1% and 5%. Adult prevalence in countries in Central and East Africa falls between 4% and 13%. With such figures is there any hope? How come they seem so accurate and so scary yet people seem unmoved?

With this as the backdrop, my visit was to the University of Abuja, to explore young minds and educate them on HIV/AIDS and its impact on their lives directly and indirectly. I also wanted to demystify the raging misconception about the spread of the disease, where they believed that it is those south of the equator that are dying and they were still safe.

I came at them double barrelled and used my experience as an example to give them a visual perception of how a person directly affected by the disease dealt with the emotional as well as financial challenges that go with HIV/AIDS. Personally I had come to the conclusion that the issue of HIV/AIDS is not in its entirety all about death. People die and will continue to die for one reason or the other. But it seems like l have been around AIDS all my adult life. I have watched my friends die, schoolmates wither and disappear for some concocted reason, and my friends’ parents fall sick, become incapacitated, die and be buried. I have played my role in fighting AIDS, worked with organizations with strong HIV/AIDS policies and community HIV/AIDS interventions programs. I have attended HIV/AIDS seminars, workshops on AIDS andlistened to the most moving experiences by victims and activists.

In spite of all this preparation there is nothing that prepares you when AIDS comes home. All l can say is that there’s an aura of hopelessness that settles around your entire being. You know that no matter what you do and will try to do the certainty of losing this person “soon” is written in stone and whatever you do is to just allay the inevitable. I have lost five members of my family within a space of 5 years; siblings aged between 30-45 years who have left behind 12 orphans between them and a series of financial dilemmas in their wake. To top it all,, our mother, who had parents’ worst nightmare of burying their own children, died of it too. If I did not know better I would think it is in the family genes but l will not go into that.

Without going into the details l believed my story represented all the facets of the impact of HIV/AIDS on an individual, a family and a community - both in the short term and the long term. In addition to being a woman, I represent the quota of HIV/AIDS that is affected and afflicted quantitatively and qualitatively by the epidemic. I played and provided the palliative care and in the end lost 5 key people in the family, all in their prime, and was left with the responsibility of looking after orphans. I highlighted the frustrations, accessibility to treatment and services, and this was in Uganda where the level of awareness and palliative care is quite high and l was well placed and privileged.

I then went ahead to create a picture of what the 5% prevalence rate attributed to Nigeria represented. Every time HIV/AIDS was discussed it was in the context of East, Central and Southern Africa, the sub Sahara Africa, which from their understanding, had to a certain extent created a belief that West Africa, the ECOWAS region, was safer. After all they only had to deal with 5% prevalence rates while “sub Saharan Africa” was dealing with 30-40% in the cases of South Africa and Botswana and 10-20 % in the cases of East and Central Africa.

Suffice to say that when it came to unpacking the 5% of 120 million Nigerian people we discovered that these 6 millionHIV positive cases were 5 times more than the 40% HIV/ADS cases attributed to Botswana who according to their total population represented about 400,000.

The aim of my story was to create a wider thinking and the need for a concerted effort and understanding of what the epidemic meant. I wanted these young people to understand that HIV/AIDS is not an issue of promiscuity or homosexuality, or who is sleeping with whom, but an issue that is affecting the very nature of societal progression. I needed them to visualise what would happen in Nigeria in relation to what had happened in South Africa. This was not very far off if they continued to assume and adhere to the current line of interpretation of the information at hand. What l had not counted on was the empathy that resulted from the talk, which was appreciated - but then it defeats the purposes because when people start pitying you they forget that the message was for them.

But my hope was not daunted and I decided to explore the environment of this august academic institution and see where these academic giants resided. What met me were mountainous rubbish heaps teeming with flies, broken sanitation systems and living conditions that defied definition. When it comes to HIV/AIDS, its heterosexually transmittal implications and disproportionate impact on women, the direct association to their living conditions was unfathomable.

It was after this that I realised that we are dealing with a situation beyond our comprehension. We came with pre-packaged information and hoped that these backward people would be grateful that “sons and daughters of the soil” had returned to save them from their lot in life. Here the priorities were very different and way beyond what HIV/AIDS connoted. They believed that it was the duty of the “government” to ensure that they had what they needed. The concept of harnessing their environment and seeing how they could survive with what they had was something they had not considered because they could not do anything about it and after all it was up to the “government” to sort these things out.

This experience informed my next visit to Funtua, Katsina State, Northern Nigeria, it very hot and with a very high Islamic influence. This time l was addressing 14-16 year old high school students and instead of talking at them I decided to have an open discussion. My message was that HIV/AIDS kills and devastates family livelihoods. We looked at its impact on an individual and how it affects his/her ability to do their work and provide for their families and how this translates to the family, the community and the region and the country as well. I kept away from the percentages and the regional subdivisions.

It yielded the same very practical results and intervention methods. In terms of content these children knew that HIV/AIDS was out there and in their communities and they were aware of the rumours. What they wanted to know then was what were they to do in the case of rape, or underage marriages, or access to preventive measures and counselling. All in all what was apparent was lack of access to information about personal hygiene, sexual reproductive health and its relationship with HIV/AIDS, sexual negotiation skills and the power relations within communities imbued with religious beliefs that promotes silence and considers certain topics taboo.

What is the problem? How are we sending out the message and is it getting to the right people? How do we create community ownership so as to overcome highly religious and cultural bottlenecks? How are we developing our communication strategies so as to identify target audiences that would have the ability and capacity to access information and respond to it effectively? One of the challenges has always been the language of communication particularly the use of statistics to explain the gravity of the situation and then using this same format to pass on this information to the affected target audiences. This is one feature that has resulted in the ineffective responses to HIV/AIDS programs. As you read the UNAIDS 2004 report it sounds like a research paper for an academic institution who are being asked to think through their parameters and see how “they” can come up with a course of action.

The dilemma we are finding ourselves in is where outsiders seem to be more concerned about our survival than we are. They seem to set the agenda and communicate it in a language comprehensible to only them. We, the so-called alleviators, are finding ourselves in places conceptually and geographically in our communities where HIV/AIDS is not considered an issue. The information is there, preventive methods there and primary curative remedies there that need to reach the people in need. We need to communicate in a language that is understandable to all so that our effort to save lives and give hope to the young is not wasted.

* Kiiza Ngonzi is HIV/AIDS Program Coordinator for Justice Africa. Justice Africa produces the Governance and AIDS Initiative Bimonthly Issues Brief, an
update on developments relevant to the issues of HIV/AIDS, democracy and
governance in Africa. Visit for more information.

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