THE BEST PROTECTION AGAINST HIV/AIDS IS SLUM ERADICATION

 

Seven African SDI Federations [1] met in Kampala, Uganda last week to discuss HIV/AIDS.

All the Federations told familiar stories – well known nowadays to the broader public. They were stories of loss and suffering, of stigma and denial. There was also the usual regurgitation of NGO speak: “sensitization”, “behaviour change communication” and the excruciatingly banal “abstain, be faithful and condomise”.

But there were other voices that got stronger and stronger as the meeting progressed, until they almost completely silenced the welfarist and moralizing white noise that normally accompanies discussions about HIV/AIDS.

In the end the message was loud and clear. Individuals might be sick and dying from HIV/AIDS, but the sub-continent as a whole is in the grip of an epidemic and not in the grip of a sickness. And you can cure an individual’s sickness by getting him or her to change behaviour, but you cannot root out an epidemic that way. You eliminate an epidemic by eliminating the social, political and economic causes that underpin it. Obviously behaviour change can reduce HIV infections but it cannot conquer the disease.

Therefore the focus needs to be on the people who are at risk and not on the people who take risks.  

With the help of Richard Mabala from Unicef, the Federation’s gained the following insights:

60% of new infections are in the age bracket of 15-24.The rate of infection in young girls is three to four times higher than it is in boys.Married women are more infected than unmarried women.This tallied with their experience and led them to conclude that behaviour change as a means of prevention is only possible in situations where the potential victims are able to exercise choice.

Young girls in the age group 15 to 24, living in very poor and marginalized communities, have very little sexual freedom – especially those who are married. There is little sense in preaching “abstain, be faithful and condomise” to young women who enjoy very little sexual freedom and who have been socialized to be submissive.Discussions of this nature led the Federations to conclude that they are not equipped or designed to be awareness raising institutions on a moral crusade to preach behaviour change. They are stigma-eradicating movements – just look at how they have transformed the perjorative term “slum” into a badge of honour. What is more they are good at tackling social issues such as access to land, housing, services. They are good at helping people unite to fight poverty.And they are good at creating a safe social space for women.

Suddenly they realized that they could be at the forefront of the struggle against AIDS by simply doing what they do best:

·         Changing the mindset of dependency;

·         Protecting mothers, daughters and sisters;

·         Creating safe spaces for women.

 Their strengths in this battle are their abilities

·         to bring women together and through savings to enable them to share their problems, even the problems of HIV/AIDS, disclosure and stigma;

·         to design, build or upgrade housing areas so that there are safe spaces for women – safe houses, illuminated streets, well managed communal toilets (when there are no services) ;

·         to give solidarity, knowledge and self confidence to young women so that they can secure freedom of sexual choice in the home, the school, the community and in society as a whole;

·         to engage state institutions around resources in such a way that treatment, services, medicines and funds flow to those in need.

 This is why the Federation concluded that in the fight against AIDS their most effective contribution is to scale up their efforts to upgrade and eradicate slums - and to do so in such a way that priority is given to the creation and the maintenance of safe spaces for women.

This is a spatial and a planning challenge best addressed by women slum dwellers themselves. It is just as much a social challenge: a challenge of collective mobilization through women’s savings schemes so that women have the social, economic and political space - in other words the power – to exercise sexual choice – in their relationships with their husbands, their lovers, their sons, and any other men on whom they depend for their livelihoods.

The Federations have a new motto: building savings schemes to eradicate slums and to protect mothers, daughters and sisters. And as a result of this meeting in Uganda the Federation members reminded themselves that this involves a whole lot more than building a house.