Waking up to HIV/AIDS

A shabby house with cracked walls and peeling paint on the bustling Rua da Resistencia is home to the country’s first association for people living with HIV/AIDS - Kindlimuka. Kindlimuka, which means wake up in Shangaan, has just buried its founder Adriano Matsinhe. He lost his battle against HIV/AIDS and was one of the first and few Mozambicans to openly declare his HIV status. Inside the centre, visitors are greeted with a friendly “bomdia” (hello in Portuguese) and asked to take a seat on the tattered sofa in the entrance hall. On the wall is a collage of photographs - people smiling and laughing. Surrounding this display of happiness and life are messages about the dangers of HIV/AIDS. Kindlimuka first opened its doors in 1998 and began with just six people. Now there are more than 180 members. “We are trying our best,” Julio, a 26-year-old counsellor working at “Kindlimuka” told IRIN. “It is very hard. There is still a great deal of stigmatism and fear. People know that we are here and that we can help them, but they are scared that someone will see them coming here and that everybody will say that they have AIDS and want nothing more to do with them. All we can say is that we are here and we will try and help if they come to us.” The organisation is one of the few places in Maputo where people living with HIV/AIDS can go to for help and support. It offers counselling on how to live with the disease. “We can’t give them any medicine, but we can help them try and understand this disease and find a way of living with it,” said Julio. “As a counsellor all I can do is be here for them and listen to them and give them some practical advise on how to take care of themselves. They come here and we weigh them, ask them what they are eating, how they are feeling. What more can we do? Look around you, we don’t have much, but we hope that what we are doing is helping.” Starting late Statistics from the UN in Mozambique show that an estimated 16 percent of adults are either HIV-positive or living with AIDS, with around 700 new infections occurring every day. Like Angola, its fellow Portuguese-speaking neighbour, Mozambique has, critics say, been slow to respond to the pandemic. “The first case of AIDS, I am told, was reported in 1985. The ministry of health was trying, and to some extent was successful, in picking up statistics from medical posts around the country to see to what degree the disease was spreading. But what we have found from statistics gathered from various international organisations and NGOs working out there, is that the problem is much more serious than foreseen,” Nyeleti Mondlane, liaison between the UN in Mozambique and the National AIDS Council, told IRIN. “At the moment, to some it might seem like a losing battle because the problem is so colossal. But we do have a strategy and of course the objective now is to stop the transmission rate and work towards reversing it.” In May last year, the Mozambican government approved a project on HIV/AIDS, with the ministry of health devising a strategic plan which defined the government’s approach to the disease between 2000-2002. The government, Mondlane told IRIN, decided that a cross-sectoral approach was needed and so created the National AIDS Council. “The government decided that this was more than a health issue. It affected education, infrastructure development, labour and all the various sectors. So we were created to develop a more coordinated approach,” Mondlane added. Mondlane told IRIN that the council had recently embarked on a campaign to educate and make people more aware of the problem. “This plan is to get information and prevention education to everybody. Prime Minister Pascoal Mocumbi, who is president of the council, has been very clear and concise, instructing us that this message has to get to every single individual,” Mondlane said. “Getting the message out there is going to be difficult. We are a very poor country; one wouldn’t say that if you look around Maputo, in large parts people are living in absolute poverty. We are dealing with a lack of adequate access to communities, lack of adequate health facilities, not enough educational facilities. This is a huge task. But I believe that what we are doing and what the government is doing is the best that it can at the moment.” Mondlane is the daughter of the first president of Mozambique, Eduardo Mondlane. People living with HIV/AIDS in Mozambique and other organisations working with people living with HIV/AIDS have been very critical of the Mozambican government’s response to the pandemic. “To my mind the Mozambican government has been very slow in responding to and reacting to this crisis,” a Mozambican woman living with HIV/AIDS told IRIN. “Of course the floods came along at the end of 1999 and the beginning of 2000, and everything else was kind of placed on the back burner. But still the question is, what is the government really doing to fight HIV/AIDS? To those of us living with the disease it seems like nothing or at least very little. The government through the council has only now come up with an information plan,” she said thumping the table in front of her in frustration. “Surely in 1994 when Chissano and FRELIMO came to power they knew about AIDS and HIV. They are educated men and women. They are not stupid. Of course they might argue that during the war there was no time to think about this disease, and I can accept that. But why in 1994 did this not become a priority. By then other countries like Uganda had already put together a plan of action. Why then is a plan to educate Mozambicans the only thing being put together now nearly 10 years after our first democratic election?” she asked. She added that one of the main issues the government should be focusing on, was helping to remove the stigma attached to HIV/AIDS. “There are still so many myths surrounding the disease, especially in terms of how it is transmitted and how it is not transmitted. Millions of Mozambicans still believe that this happens to only a certain kind of person or only to a man or only to a woman. Not enough is being done to say that it can touch every single Mozambican in every part of this country. Look at me. Do I look like I am HIV-positive? I work for an international organisation. I am educated. I was married when I discovered I was HIV-positive,” she said. “We should be learning from the experiences around us, from Uganda, Senegal and look at their success stories and then look at what mistakes have been made in countries like South Africa, not trying to start from the very beginning.” Not enough political will Jeanne Stephens, general manager of Austral Consultoria e Projectos, a consulting firm advising people on doing business in Mozambique, told IRIN that two major problems with the present policy was that there was not enough political will to effectively deal with the disease and that some members of the government saw this as a “manageable” disease. “The fight against HIV/AIDS in Mozambique will not move forward and will not be effective until there is clear political leadership and political will on the issue. Leaders in this country have to face the problem head on and, I would say, show courage in making sure that Mozambicans truly understand the potentially devastating effects that the disease can have and is starting to have,” Stephens added. She said there was a perception - and even a belief - among some members of the Mozambican government and the ruling elite that HIV/AIDS was a manageable disease. “There are those in these two groups who believe that this is a manageable disease simply because they can afford anti-retroviral medication. They see no reason why they should change their lifestyles. If they do become HIV-positive, they say, they will simply take the anti-retrovirals, which they argue will prolong their lives until a cure comes along. For them it might be ‘manageable’, but for the majority of Mozambicans and indeed Africans it is not. Perhaps, and this is sad to say, more of the elite classes have to start dying for the powerful ones to become more responsive to the disease,” said Stephens. Without this political will and indeed commitment, AIDS activists and people living with HIV/AIDS argue, organisations like “Kindlimuka” are fighting a losing battle. “We need the government to recognise what we are doing,” Julio told IRIN. “We can’t do this alone. Our leaders have to stand up and say that people must listen to what we are saying. We are not asking for money. We are saying that our leaders need to say to Mozambicans – ‘AIDS is killing our people’. How can I tell a boy that he must change his ways if men in government are not even listening to us?” For information from the UN Special Session on HIV/AIDS and a selection of IRIN features on how Africa is fighting the pandemic, please see: http://www.reliefweb.int/IRIN/webspecials/hiv_aids/index.phtml