SAVING COMMUNITIES THROUGH CREATIVE HIV PROGRAMS

Before 2006, the eleven rural communities with 13 primary and 5 post primary schools in Agwa; Oguta Local Government Area Imo state was experiencing loathsome cases of teenage pregnancies and HIV/AIDS infections especially amongst pupils and students in primary and post primary schools.

The HIV pandemic has existed for many years without adequate prevention measures thus, families and community members find themselves confronted with increased expenditure for medicines and materials needed for home-based care and costly funerals. Some families even resorted to burying their wards alive to avert the cost of caring for their AIDS-infected relations. An account has it that a man had the temerity to bury his AIDS-infected daughter alive with the assistance of some able-bodied youths who later leaked the information. The man in question simply did away with his AIDS-suffering daughter to avoid the cost of treatment and stigma associated with the AIDS pandemic.

Stigma and discrimination against people living with HIV was at an atrocious level. Illness and death due to AIDS have far-reaching effects on families and communities, thus prevention of HIV infection and education becomes imperative and required that joint efforts be made by all sectors. But, worst still was that many of the indigenes attribute AIDS-related deaths to the anger of the gods and therefore they concentrated communal efforts on the credulous cleansing rituals and placation of the local deity instead of HIV prevention programs

As more and more adults die, communities face the task of helping care for an increasing number of orphaned children and even incapacitated adults alike.  The situation was complex and dumbfounding.

Every family has one ‘emergency’ mother or father. The spill over was increase in mortality rate due to complication from child bearing. The young boys that are affected by toe-curling unemployment and idleness found succor in becoming fathers thus; young grandfathers was increasing.

Although, it could be a thing of joy to many parents to be grand-fathers and grand-mothers even when they have to cope with the merger resources to cater for an unplanned increase in families. The burden of bringing up babies, caring for the young mother and maintain other family members with the already overstretched limited resources cannot be over emphasized.

The young fathers therefore have to engage in either crime or do menial jobs to raise money to sustain their increasing families.

Their future has been punctured; it will take several years to bring themselves back to the realities of social existence. Here indeed was our concern.

We proposed to so many organisations, and government agencies to support us to implement an educational and awareness program in this lethargic clan, but alas, we were confronted with the incomprehensible “We are sorry, we don’t have funds”.

We continued to search for funds until, the Federal Republic of Ireland through its in-country micro project scheme in Nigeria, granted us funds for three years. Although the funds were limited, it was the best thing that happened to the Clan during that period.

With the funds, we moved in earnest to begin the HIV prevention services in the schools and outside the schools.

A study conducted by  Dr Basu Falguni an international research specialist placed on a short term volunteer program by VSO  in our organisation indicated that the awareness level of students about HIV/AIDS and STD was below 15% at baseline, in some areas the misconception about HIV and its mode of transmission ranked higher even amongst the grown up students. Many of the returned questionnaire indicated that students still think that HIV could be transmitted by mosquito, bed burg and even through toilet.

Therefore the need to carry out an integrated HIV/AIDS prevention programme in this community that targets children and adults alike becomes de rigueur in other to redress the misunderstandings and the underlying factors that increase the vulnerability of people in this communities especially among children between the ages of 5-18 years since many of them have not been contaminated with sexual lust.

It was this low level awareness and knowledge in the community that provoked the HIV/AIDS intervention program in the selected primary and post primary schools in Agwa by CHISTRE and Mgbala Agwa Youth Forum.

The three-year intervention program ran in the schools and in the entire community of about 450,000 people. Unfortunately, the program was the first intervention by any organisation to educate the people and prevent the spread of HIV as well as increase the knowledge of the community members about the HIV/AIDS scourge.

In an elated voice, the traditional ruler of the Town, Eze I.O Asor in one of the programs commended the effort of CHISTRE and Mgbala Agwa Youth Forum in bringing the program to his community and said they will be remembered for a long time to come, “this organisation has chosen to save the life of our children and our families, when other groups and politicians are busy pursuing political appointments, Mr. Nduka Ozor, the Project Director of CHISTRE and the Mgbala Agwa Youth Forum Co-ordinator chose the path of messiah to save our community from this dreaded HIV/AIDS. God will definitely reward him”, he prayed.

AGWA COMMUNITY

Agwa is a mid-sized community of Igbo people, located in Oguta local government area of Imo State, Niger Delta region, approximately 45 kilometers from the Owerri capital city of Imo state. Nigeria.

Largely spared by the devastation of the 3-year Nigerian civil War from 1967-1970, the town is situated on a tableland in a green belt including mostly palm and gmelina trees. It is reached via a 6 kilometers dirt road off the highway to Onitsha, a major south-eastern market. The principal form of industry is agriculture with farming carried out using traditional methodologies. The Town has rich heritage of culture that is distinctly different from other social groups in Oguta Local government Areas. The people are easily identified by style of dress, dialect, folklore, customs and practices including wife heritage. The Town lack social amenities, like paved roads, electricity, hospitals, pipe borne waters and good schools.

Because of their relative isolation from the mainstream, the lifestyle of Agwa has retained a much more traditional characteristic. While retention of identity and other traditional ways of life is highly valued and is obvious strength, superstition and ignorance are significant constraints to the development of the people, and its people are not well developed economically and socially as other comparable communities elsewhere in Imo state. Poverty, isolation and the crude traditional practices within the community are significant issues for the risky behavioral tendencies to HIV/AIDS and other sexual health. The knowledge of HIV/AIDS is very low because of the lack of education and medical facilities. The major problem with development in Agwa is that the community is not accessible, because of the shortage of basic amenities and the low level of literacy amongst the people. This makes them easily forgotten since they don’t have a platform to discuss local issues with government.

The ravages of HIV/AIDS in the community affect both men and women. The rate of infection and sickness resulting in death follows a similar trend in Agwa to many comparable communities in Nigeria where HIV/AIDS is also pandemic. Adolescents in these communities are particularly vulnerable to infection by HIV/AIDS due of their involvement in risky behaviour such as unprotected casual sex and multi-partner relationships. Because of tradition, it is difficult for parents and children to talk about sex and sex related matters such as puberty, pregnancies, HIV and other sexually transmitted diseases.

Due to the lack of medical care within the community, there are no official statistics regarding the HIV/AIDS situation in Agwa community, but there are palpable cases of HIV infections and deaths, which have risen steadily over the years.

WHAT CHANGED AFTER THE PROGRAM

One hundred and thirty teachers were trained on the Basics of HIV/AIDS, HIV Counseling and Testing, Prevention of Mother to Child transmission of HIV/AIDS, Condom use and condom negotiation, and HIV/AIDS preventions.

The objective is to enable the teachers pass the same knowledge to their students during classes

In all over 35,000 students were reached with accurate information on HIV/AIDS. Six anti-aids clubs were formed in six post primary schools. Each of the club has an average of fifty members. Agwa secondary school alone has seventy-five registered members, and fifty members that were not formally registered. The have carried out seminars in the school for about five times and were funded by CHISTRE.

CHISTRE has been able to develop an HIV educational curriculum for all the schools where the program is running. Forty five minutes is now allocated for the teaching of HIV and related subjects in the classes.

Parents are no more withdrawing their children from classes during sex education classes, and the CTY teachers are no more harassed by parents. A framework has now been developed for the education of pupils and students in the schools where the CTY project is running. Awareness and knowledge level about HIV/AIDs has increased from the baseline of less than 15 percent to 65% by all the students that participated in the project.

31 young girls who pledged to remain virgin maintained the commitment at least during the three years project life. Condom consumption increased. A research conducted amongst the patent medicine dealers confirmed an increase in condom consumption

Estimated 280,000 people were reached during the program. The annual HIV/AIDS world Aids day was celebrated by the students in the community. Drama, musical concerts, poems and role plays were conducted by the anti-aids club members, during these periods, members of the communities were reached with other information, education and communication materials.

Ten nurses in the community health centres were trained on the universal basic precaution, they were also taught on HIV counseling techniques .Interpersonal communication as well as basic facts about HIV/AID.

CHALLENGES

Whilst the project recorded huge success, it also had severe challenges that affected the project.

The funding was inadequate to all the components of the HIV preventions, HIV counseling and testing, Stigma reduction, and care for orphans and vulnerable students.

Other challenges include:

Inadequate capacity of the staff to facilitate the workshop, we therefore used external resource persons, this was costly.

Apathy on the side of some trained teachers who refused to conduct classes on sex education, because according to them, it is a taboo to talk sex with children.

Tradition was another challenge we encountered during the project, sex education is a taboo, and some of our teachers were openly confronted by some parents for discussing sex with their female children.

Transportation was another challenge; the lack of good transport system in the community affected the workshops. Participants had to trek some 5-8 kilometer to the only venue of the workshop.

Further more there was minimal supervision due to lack of good transport and environmental terrain.

Inability to accommodate out-of-school children

Lack of instructional materials/teaching aids.

Inadequate classroom infrastructure

Transfer of HIV/AIDS trained teacher

Instability in academic calendar

Lack of skills and delivery method: Teachers still show signs of cultural and hindrance during discussion about sex and HIV.

Restriction of Training to two teachers from each of the schools is not ideal for the program.

Clash with school program

RECOMMENDATIONS

We strongly recommend that the project continue for the next three years, in other to build strong sustainability arrangements. The passing out of some of the trained Peer health Educators from the schools affects the sustainability of the program, and therefore we had to train and retrain annually. Also, the transfer of trained teachers affected some of the schools lessons. At a time, all the trained teachers from 4 schools were transferred outside the community, and we had to make an emergency plan to replace the teacher.

To avoid such situation, we had to train all the teachers in the entire community, with the believe, that they will still be relevant in the schools when they are transfeered.But to our surprise; three of the teachers were recently transferred outside the Town. Since we don’t have the control of the teacher’s transfer, we are planning to meet with the ministry of education to discuss this problem with them.

NOTEWORTHY

31 young girls formed “no sex till marriage” group. Membership increased to 47 within 4 months.

Parents are now turning to CHISTRE and Mgbala Agwa Youth Forum for sex education and counseling.

After the first year of the project, teenage pregnancies in school reduced significantly.

350 students voluntarily went for HIV testing.

5 HIV anti-clubs were formed in five schools.

Produced a HIV/AIDS educational film.

230 community members participated in one of the interactive sessions where sex education was intensively discussed.

The traditional ruler of the community gave his Royal Blessing to the project, and called on the local government to focus on community health.

We want to continue this important program in all the schools, and we will be happy to receive assistance from you in some ways like in.

• Technical Supports and resource mobilization.
• Development of more partnership with other international youth organizations.
• You may wish to research for us interested partners and donor agencies
• Fund raising for the sustainability of the program
• Information Technological exposure of our participating students.
• Youth Exchange program activities
• Volunteerism
• Supporting part of our Aids club activities.
• Development of Reproductive health programs
• Income generating activities for the Virgin club.
• Direct donation to our PayPal Account (see our website,www.mgbala-agwa.org)

You can contact me for more information through the address below

Nduka Ozor

Mgbala Agwa Youths Forum

c/o 21,warehouse road Apapa

lagos Nigeria

www.mgbala-agwa.org

mayfnigeria yahoo.com

By Nduka Ozor

In many rural communities in Nigeria, the HIV/AIDS pandemic is prevalent and affects all layers of society. Illness and death due to AIDS have far-reaching effects on families and communities, thus prevention of HIV infection requires that joint efforts be made by all sectors, organizations, and even the community coordinating mechanisms.

Although communities still differ in the extent to which they have already been affected by the HIV/AIDS pandemic, current projections indicate that, if comprehensively integrated control measures are not put in place, our rural areas may witness an explosion in HIV infection similar to that of South Africa where the prevalence rate surpassed manageable proportions.

In the South East zone, particularly in Imo where the pandemic has existed for many years without adequate prevention measures, families and community members find themselves confronted with increased expenditure for medicines and materials needed for home-based care and costly funerals. Accounts even illustrate how some families have resorted to burying their wards alive to avert the cost of caring for their AIDS-infected relations as in one case in Obudi–Agwa, Oguta Local government Area of Imo State. An account has it that a man had the temerity to bury his AIDS-infected daughter alive with the assistance of some able-bodied youths who later leaked the information. The man in question simply did away with his AIDS-suffering daughter to avoid the cost of treatment and stigma associated with the AIDS pandemic.

Many of the indigenous attribute AIDS-related deaths to the anger of the gods and therefore concentrate communal efforts on the superstitious cleansing rituals and placation of the local deity instead of HIV prevention programs. As more and more youths and adults die, communities face the task of helping care for an increasing number of orphaned children and even incapacitated adults alike, therefore the need to carry out an integrated HIV/AIDS prevention programme in the rural community that targets children becomes imperative in other to redress the misunderstandings and the underlying factors that increase the vulnerability of people in the rural communities especially among children between the ages of 5-18 years since many of them have not been contaminated with sexual lust.

It is on this premise, that the Centre for HIV/AIDS and STD Research (CHISTRE) with funding support from Irish Aid implemented a pilot HIV/AIDS educational program in 13 primary schools 6 secondary schools in Mgbala Agwa, in Oguta local Government Area of Imo State, the aim is to Catch the Children Young towards making a generation without AIDS in the sleepy town of Mgbala Agwa.

However, educating children about healthy behaviour can be a daunting task, especially in a developing country like Nigeria where expertise and facilities are lacking. Children look up to their parents, teachers, and in some cases, their peers as the most useful and helpful sources of information on sexual health issues, including HIV and AIDS. This makes it imperative for comprehensive preventive measures to be implemented if the future of our children is to be protected. CATCH THEM YOUNG PROGRAM (CTY) therefore presents a good HIV/AIDS prevention strategy that targets children, the youths and their parents to change their attitude and perception towards sex education that promotes abstinence and create fear in the consequences of the HIV virus.

The AIDS project aimed at educating young people about sexual health issues before they attain sexual maturity. It also sought to demystify the age-long tradition of not discussing sex with children. CHISTRE further aimed that the project would elicit active discussions amongst people in the community on other health challenges through the various education-entertainment programs.

The program prepared teachers, the youths, pupils, students, parents and peers on how to raise awareness of healthy sexual behaviour for children in primary and secondary schools as well as the entire community through a well-structured educational-entertainment program.

The project was implemented in 13 primary and six post primary schools in Mgbala Agwa Community. Mgbala Agwa is a mid-sized community of Igbo people, located in Oguta local government area of Imo State, Niger Delta region, approximately 25 kilometers from the Owerri capital city of Imo state, Nigeria.

Largely spared by the devastation of the 3-year Nigerian civil War from 1967-1970, the town is situated on a tableland in a green belt including mostly palm and gmelina trees. It is reached via a 6 kilometers dirt road off the highway to Onitsha, a major south-eastern market.

The principle form of industry is agriculture with farming carried out using traditional methodologies.

The town has a rich heritage of culture that is distinctly different from other social groups in Oguta Local government Areas. They lack social amenities, like paved roads, electricity, hospitals, pipe borne waters and good schools making the community remote in terms of social and economic activities.

Because of their relative isolation from the mainstream, the lifestyle of Agwa has retained a much more traditional characteristic. While retention of identity and other traditional ways of life is highly valued and is an obvious strength, superstition and ignorance are significant constraints to the development of the people, and its people are not as well developed economically and socially as other comparable communities elsewhere in Imo state. Poverty, isolation and the crude traditional practices within the community are significant issues for the risky behavioral tendencies to HIV/AIDS and other sexual health.

At the end of the pilot project, various milestones that could be replicated were recorded. In one of the training sessions, 31 young girls between the ages of 13-17 years in the presence of their parents declared that, they would keep their virginity until they get married. Other female students between 20 years and above that also participated in the program vowed not to have sex again no matter the pressure. The six post primary schools that participated in the project have since formed Anti-Aids clubs that now has more than 200 hundred members, 70 percent of them being young girls. The memberships to the Anti-Aids clubs are increasing and HIV/AIDS issue dominates the group discussions in the schools as well as in the community; that is what CTY aims to achieve. CHISTRE has also developed a monitoring mechanism to ensure that these declarations made by the young girls are maintained.

To realize the vision of making a generation without AIDS in the rural communities, approaches as was developed by CHISTRE need to be supported and sustained. I have my doubts if the program will have same impact in the urban areas due to contending variables.

For more information on how you can collaborate with Mgbala Agwa Youth Forum, please contact us.

By the Centre for HIV/STD Research (CHISTRE)

The fundamental idea for this activity is to provide for the School Children the information, which is ultimately targeted at raising awareness about HIV/AIDS and other sexual matters. This will undoubtedly promote behaviour change and encourage healthy living among the School Children.

The program was organized in the Schools to ensure that a greater number of Children participated. Moreover, the School is seen as a veritable spot for the program because of its formal and organized nature.

Teachers from the 18 Schools were trained on the basis of HIV/AIDS and Communication modes and later co-opted into the program after advocacy with the authorities of the Schools, which culminated in the approval of periods for the study.

Meanwhile, total of 42 teachers participated in the program with two personnel supervising the activities of the teachers during the program; which lasted for three months beginning from May to July, 2007.

The teachers reported their activities on daily and weekly basis following the scheme of work adapted from the FAMILY LIVE AND HEALTH EDUCATION CURRICULUM and approved by the Centre for HIV/AIDS & STD RESEARCH (CHISTRE).

At the end of the 3 months, a total of 22,635 Pupils and Students were reached; with the following weekly breakdown:

Week 1: 3876
Week 2: 3931
Week 3: 5978
Week 4: 2742
Week 5: 3236
Week 6: 1882
Week 7: 774
Week 8: 200

However, the program was faced with some challenges. These include; dwindling and fluctuation in the numbering attendance due to non-compliance with the order of the School for Pupils to pay certain fees.

Lack of instructional materials: This greatly affected the program as there are absolute lack of materials for effective communication being that HIV/AIDS is a new concept in School.

Lack of Qualified Teachers: Most of the Teachers have no knowledge about HIV/AIDS prior to the program and this has its effect on the program.

Indifference: Some Head Teachers are opposed to the teaching of sex and disease in schools affected the smooth running.