Feature

Bridging the Information Gap
Although Uganda is lauded for its relatively low HIV-prevalence rate of 5% among adults, in the small district of Busia, HIV is rampant—34% of the population is infected. Located along the trans-African highway and bordering Kenya, Busia is paying a steep price for its commercial activity. Merchants from all of Uganda travel to Busia town to capitalize on the import-export economy, truck drivers delayed at customs spend up to three days in the town waiting for clearance, and a nearby fishing village makes a handsome profit from the sale of its daily catch. A steady flow of cash enabling commercial sex coupled with deeply rooted traditions that put practitioners at risk of HIV-infection make residents of Busia particularly vulnerable.

HIV/AIDS was discovered in Uganda in 1983; until five years ago there was little knowledge of the disease in Busia. A UNICEF survey indicates that while only 30% of the Busia population was aware of HIV in 1999, 98% of residents were educated about the virus by 2002. Friends of Christ Revival Ministries (FOC-REV), a community based organization active in three Busia sub-counties, now supported in part by the Hope for African Children Initiative (HACI) of Uganda, has been bridging the information gap. John Francis, manager of FOC-REV, indicated that when FOC-REV began working in Busia “there was literally no information about HIV—they were attributing it to witchcraft.” Through awareness raising campaigns and community outreach, FOC-REV is trying to curb the onslaught of the AIDS pandemic in its backyard. Currently, FOC-REV is aiding people living with AIDS and orphaned children, as well as encouraging community members and leaders to modify practices that can spread HIV.

Adherence to traditional ritual common to Busia is one factor contributing to the high HIV-prevalence rate. Presently, most people understand the modes of HIV transmission; however, changing cultural practice has proven more difficult. John Francis estimated that 90% of the population visits witchdoctors for protection and cures. While many have strong allegiances to traditional healers, unaffordable western medicine does not hamper healers’ business. If a person falls ill, she will visit a witchdoctor with her family. Oftentimes, traditional healers cut each family member’s forehead to insert medicine. The recycled blade can transmit HIV. Witchdoctors, who are HIV-positive, are often culpable for the infection of female clients. Women unable to conceive are administered an herbal remedy transferred from a witchdoctor’s genitalia during intercourse. Although many women are aware of the risk involved, bareness is considered a graver curse than HIV. Traditional birth attendants’ failure to sanitize birthing instruments also contributes to infection. Cognizant of the influence of traditional healers, FOC-REV educates witchdoctors about HIV and encourages healers to modify dangerous practices by using sterile blades and condoms. They also ask them to refer HIV-positive patients to the local clinic for further care.

In addition to educating witch doctors, FOC-REV is teaching community members about the hazards of certain customs. The Olunganyo ritual, a funeral rite, is conducted nearly every Friday in Busia. During this three-day ceremony, friends and family members of the deceased try to reincarnate the dead by creating new life. Safe sex is rarely practiced. Attending the local market on the days when villagers purchase food for the Olunganyo feast, FOC-REV drama clubs distribute condoms and perform skits elucidating the importance of safe sex in an effort to reform this practice.

Wife-inheritance and wife-sharing are also endemic to the area. If a woman is widowed, her brother-in-law may take her as a wife. This practice is critical to a woman’s protection and her children’s wellbeing. If she refuses, she is likely to be considered a prostitute and have her property taken away by her late husband's family. It is also customary for a man to offer his wife to his brother or friend, should he come to visit. The multiplicity of partners is more common—and more dangerous due to HIV.

Busia is also jeopardized by its transient population. Truck drivers passing through “download a lot of HIV violence in the area,” John Francis indicated. Fishermen also contribute to the problem. Situated along Lake Victoria, Busia has a lucrative fishing economy. Expendable income affords commercial sex, but as yet, the fishing community remains ignorant about AIDS. Fishermen, who work at night and sleep while villagers are taught about HIV, are difficult to target. Further, businessmen from distant districts settle in Busia to conduct trade. John Francis explained that the traders’ children grow up in Busia, but have little interaction with their extended family. Should their parents die of AIDS, they are left without support. While orphaned children in most of Uganda are absorbed into relatives’ homes when their parents die, orphans in Busia live on the street.

With HACI’s support, 242 orphans are benefiting from FOC-REV’s activities. Currently FOC-REV is catering for one orphaned child in each registered family, in an effort to reduce the financial burden on caretakers. In one family, in which a grandmother is looking after thirty orphans, the challenge is formidable.

FOC-REV queried the community to assess what would be most helpful when “HACI came in and said ‘let’s support the children,’” John Francis stated. 30 families with primary school-age children have received training in piggery management and production, and two piglets. Orphans and caretakers gave been taught how clean and deworm pigs as well as how to prepare locally made feed. FOC-REV intends to help families crossbreed the local pigs with other varieties in order to produce a more sizeable stock. As the children grow they will not only learn valuable skills in animal husbandry, but also the sale of the pigs’ offspring will finance their secondary school education. John Francis, expressing the community’s reaction to the project, said, “the people have ownership—when they own it you can tell that they are happy.”

In addition to the piggery project, FOC-REV has trained and supplied many families with goats and improved seeds; vulnerable children congregate biweekly for a day of activities, skills workshops, counseling, and health care; and forty orphans are paired with local artisans and are trained in marketable skills.

Although Busia’s unique location and traditions compound its inhabitants’ risk of HIV infection, FOC-REV is educating the community to address the problem head-on. Aiming of foster self-sustaining communities, FOC-REV and HACI are building the capacity of children and their guardians to cope with their situation and prepare for a brighter future.