HIV-positive Sudanese refugees fear stigma in homeland

Thousands of refugees in northern Kenya's Kakuma camp have signed up to be repatriated to their native southern Sudan. Among them is James Nhial Diew, 16, who arrived in 2004 and is excited to be going home, but afraid of revealing his HIV-positive status to his family. He said he might find the courage to do it when he gets to Sudan. "I just told them that I am sick and they told me to come home so they can nurse me there," he said. Although prevalence among the refugees is low, the communities they are returning to are suspicious that returnees will trigger the spread of HIV/AIDS in the region. "I sympathise with those who are HIV-positive and are going back home to southern Sudan. In some regions, people even suspect everybody that comes from exile has AIDS - what if they come to know an actual person with AIDS?" wondered John Wichyual Reath, secretary of the Nuer community in the camp. Unlike the refugees, who have received HIV/AIDS education, prevention, care and support in the camps, the residents of southern Sudan are poorly informed about the disease. A 2005 survey by the Sudanese National AIDS Control Programme and UN agencies found that less than 10 percent of young Sudanese had a clear understanding of how to prevent HIV or knew what a condom was. According to health workers in the camp, which is home to some 71,000 refugees, the lack of knowledge among the more recent arrivals was proof of this. "When we compare the experience of those refugees who came from Sudan recently with those refugees who had been here since 1992, we realise that people in Sudan know very little about HIV/AIDS," said Charles Ogosi, reproductive health focal point for the International Rescue Committee in Kakuma. "HIV is already there [in the region] and it is not something you can blame on anybody," said Ben Parker, communications officer for the UN Children's Fund in southern Sudan. EQUIPPING REFUGEES FOR RETURN UN agencies and NGOs are intensifying their efforts to improve the refugees' knowledge of HIV/AIDS ahead of their repatriation. "We are having awareness training on HIV prevention among the returning refugees not only so that they can help themselves, but also so that they can assist those who stayed behind in the south," said Emmanuel Nyabera, spokesman for the UN refugee agency, UNHCR, in the Kenyan capital, Nairobi. "We want to use them as tools of information there." UNICEF's Parker said groups of HIV-positive people in the southern towns of Yambio and Yei were educating people about HIV/AIDS to "try and get past the stigma issue". The agencies working with refugees in the camp are doing their best to brace the refugees for their return, according to Makonen Tesfaya, the UNHCR programme officer in Kakuma. "Before they travel we distribute condoms to them, inform them on obvious ways of protection against HIV and, mostly, that they should use our medical services on the other side [of the border, in Sudan]," he said. Nyabera said UNHCR was urging HIV-positive refugees not to return until they were sure that antiretroviral (ARV) therapy would be available in their home towns and villages. "The returnees are receiving ARVs in Juba, Yei and Kajo Keji, and we are trying to expand these services as much as possible."