BUKAVU, 3 August 2007 (PlusNews) - In the volatile eastern
Democratic Republic of Congo (DRC), where people are often more
concerned about their safety than HIV/AIDS, widespread stigma and
discrimination are driving the epidemic underground, especially
in the province of South Kivu.
"When my neighbours learnt that I was positive, they made sure
that I was thrown out of the rental house I was living in with my
wife and three children," said Borauzima Lukabia, 34, in Bukavu,
the provincial capital.
"Because of being stigmatised and discriminated upon, we often
lack the means to earn a livelihood," he said. "Take me, for
instance: I am 34, yet I have no work; no one will employ me. My
biggest problem now is hunger; I am on ARVs and this means I am
hungry all the time, yet I have no means of earning a living."
Getrude Muhemeri, the director of Fondation Femme Plus, a
national non-governmental organisation (NGO) offering support to
HIV/AIDS infected and affected people, told PlusNews that most
people living with HIV/AIDS had suffered greatly in the
intermittent conflict in the province during the past 10 years.
"War-affected people are mostly very poor; those infected often
have to face a lot of stigmatisation, in addition to all the
other problems related to violence," she said.
Fear of rejection
Although Bukavu has an estimated population of half a million, a
spot-check of NGOs supporting people living with HIV/AIDS showed
that only a few thousand were being assisted, which most NGO
officials attributed to fear of stigma and discrimination if the
HIV-positive status of a person should become known.
"In conjunction with our partners [other NGOs and governmental
organisations], we provide psychosocial support to people living
with HIV/AIDS; we also sensitise the families of those infected
to get them to accept their relatives, but is not enough, said Dr
Alex Kabanga wa Kabanga, a medical supervisor at NGO Catholic
Relief Services (CRS).
"More efforts need to be made to have whole communities
sensitised against discriminating and stigmatising the infected,"
he said. Although most people in the province knew what AIDS was,
many still shunned their relatives who had declared their status.
"When someone is told that their brother has HIV, their response
is often one of fear and the desire to give up that person to be
cared for by an organisation; they seem to want nothing to do
with an infected person," Kabanga said.
"It is because of this fear of stigmatisation that a lot of
people would rather not reveal their status."
Kiungi Safi, 34, and her husband, a soldier who is also
HIV-positive, said stigma meant that the only house they and
their three children could rent was in an area prone to flooding.
"Because of this, my husband and I are always suffering from
opportunistic diseases that we get whenever our house is flooded
during the rainy season," she said.
"My family depends on the little salary my husband gets from the
army ... about 10,000 Congolese francs [US$20]. It is not enough
to ensure we have food, let alone trying to rent a house in a
better neighbourhood and, anyway, we will be thrown out if a new
landlord found that we had AIDS."
Kabanga said, "A lot of people who know they are infected do not
own up [to their HIV-positive status] because they fear
discrimination. They say, 'maybe my wife will leave me, my
children will be shunned by the neighbour's children, who will no
longer want to play with them, fearing they will get infected, or
the landlord will throw me out'."
CRS has been operating in Bukavu since 2005 and works with a
network of about 100 volunteers, sensitising those who may be
living with the virus and do not know it, as well as the families
of people who have declared their status, to promote acceptance
and support in the community.
"We use volunteers who visit people's houses, VCTs [Voluntary
Counselling and Testing centres], market places and other public
areas, and our volunteers often have to make several visits to
one area before people begin to open up."
Supporting HIV-positive people in Bukavu
The organisation's biggest project is known as AMITIE, an AIDS
mitigation initiative that offers care and support to people
living with HIV, as well as orphaned and vulnerable children
Kabanga said they had recorded some 1,137 people living with
HIV/AIDS in Bukavu, to whom they provided psychosocial support
and referred to medical facilities and NGOS where they could get
antiretroviral therapy. CRS also assisted 1,843 OVCs, 1,537 of
whom were of school-going age, but it could only pay school fees
for 770 of them.
"We should pay school fees for all these children but our funds
are stretched; all of them need food, others need support to get
vocational training, and others need legal aid to benefit from
their late parents' properties."
He said an issue of great concern was providing food to people
already on ARVs. "AMITIE is a four-year programme, and we hope
that our donors [USAID] will increase its aid annually to cover
all these needs," Kabange said.
The main donors to NGOs, like CRS and Fondation Femme Plus, who
work with several other local and international organisations to
support people living with HIV/AIDS in Bukavu, are USAID and the
Global Fund on HIV/AIDS, Tuberculosis and Malaria. The
government's National Multi-Sectoral Programme for the fight
against HIV/AIDS, known by its French acronym PNMLS, is the
coordinating agency for all the organisations dealing with
Dieudonne Zirirane, the HIV programme coordinator for Association
Sante Familial (ASF), a national NGO affiliated to Population
Services International (PSI), said the NGOs working with HIV/AIDS
met every month, under the chairmanship of PNMLS.
The major challenges in the fight against HIV/AIDS in South Kivu
included the vastness of the province; insecurity, which hampered
access to vulnerable communities; funding; an increase in sexual
violence in war-affected communities; and a lack of adequate
Most of ASF's activities were focused on supporting the health of
vulnerable communities, especially those infected and affected by
HIV/AIDS, in four main programmes that covered HIV prevention,
family planning, preventing malaria, and a safe water project.
PSI, in conjunction with ASF, ran several social mobilisation
activities aimed at informing the public about HIV/AIDS. "We
undertake these activities to break the barriers, so to speak, in
a bid to demystify HIV/AIDS to the largest number of people,"
"We target commercial sex workers, soldiers and the police,
demobilised soldiers, truck drivers, the youth as well as people
belonging to various religious faiths."
Approaching the targeted groups was achieved mainly by peer
education, and a small group in every target group was trained to
inform their colleagues about HIV/AIDS.
"In the field, the peer educators give out reference cards to
whoever wishes to visit a facility for testing and counselling;
the cards have a list of medical facilities and VCTs centres,
where potential patients who produce them get served free of
charge," Zirirane said.
ASF-PSI also marketed affordable condoms via a network. "Condoms
available in health centres and other public places are provided
under a ministry of health programme, but we realised that a lot
of people did not like the free condoms, so they prefer to
instead go through our network where they get to purchase a pack
of three condoms for 50 Congolese francs [US 10 cents]."
Zirirane said the prevalence rate among pregnant women had been
found to be about three to four percent; two percent among those
who donated blood; four percent among documented victims of
sexual violence, and 20 percent among commercial sex workers.