Hidden Voices of HIV/AIDS

TANZANIA has been ‘living with HIV/AIDS for 34 years’!

There is an entire generation of young people who were born in the wake of the HIV/AIDS epidemic and this generation has not experienced a world without HIV/AIDS.

To them, the two words- HIV and AIDS are a fact of life which they have had to live with not knowing that there was a time in the history of our country when HIV and AIDS were words that had not been coined and that the people of that generation had never envisaged even in their wildest dreams that a disease without cure would sweep like a demon wind into our lives and take away our loved ones without mercy .

The grief; the waste of life and resources; the emptiness left by this merciless disease cannot be described in words. One has to live it to be able to feel the magnitude of sorrow; waste; emptiness; and the utter ruthlessness of HIV and AIDS.

Tanzania has been fighting HIV and AIDS for 34 years. We have been fighting an enemy whom we cannot see except what we see is the destruction of lives and resources. We have been fighting an enemy who is cunning; smart; adaptive to the environment and like a chameleon, can change in order to have camouflage while we are out in the open in a battlefield where we are totally exposed to the enemy.

Tanzania has had to go with a begging bowl to donor countries and to funding agencies and like a mother during a state of war, begged for resources and expertise so that her children would not get annihilated. HIV and AIDS has made us forget dignity and we have had to swallow our pride and like a mother whose house is under siege; Tanzania has had to swallow her pride and accept hand outs in order to save her children. There is no dignity when it is a matter of life and death and a mother would go to great lengths to preserve, nay, to save the lives of her children!

HIV and AIDS has been an unwanted companion in the lives of Tanzanians for 34 years. Statistics about the reduction of the rate of infection; more people opting for VCT; people living with HIV – PLHIV on government sponsored ARTs ought to give us hope however, as we mark 34 years of HIV and AIDS, what we see in the mirrors of our minds are the names; the faces; the loss of our loved ones.

The grief; the loss; is indescribable and each family; each neighborhood; each place of work; each segment of our society has experienced the grief; the loss and while we remind ourselves about the 34 years of HIV and AIDS; we should remind ourselves about our national VISION “To have a Tanzania in which our children are free of HIV/AIDS”.

The VISION has been our oath; our pledge and our commitment in this fight however, in order for ALL our children to live in a world free of HIV and AIDS, National HIV/AIDS Intervention Plans have to be inclusive of all stakeholders without bias; stigma or discrimination otherwise that dream of our children living in a world free of HIV/AIDS would remain but a sham.
This calls for juggling of priorities and agendas; community conversations; making frequent social diagnosis to get a measure of societal response towards HIV/AIDS Intervention among peripheral groups; the Key Populations, and devising ever more innovative strategies. This is called ‘walking the tight rope’ which we cannot avoid.

The figure left is an illustration of the SEX CYCLE in which people who engage in sex with more than one partner, in effect, becomes part of a circle of sexual partners through their partners, and whom they often do not know. Source: Leila Sheikh/CHRP/2012.

Sexual Health encompasses health and well-being in matters related to sexual relations. It deals with the most intimate and private aspects of people’s lives, which can be difficult to write about and discuss publicly. As a result, the public misunderstands many sexual health and sexuality matters. In addition, cultural sensitivities and taboos surrounding sexuality often prevent people from seeking information and care; and preclude the government from addressing the issues.

Yet, sexual health profoundly affects the social and economic development of countries. When women die in childbirth, children are orphaned. When girls must take over care of their siblings, they drop out of school. Without an education, girls often marry and begin having children early, which can jeopardize their health and limit their opportunities to add productively to their community and their country’s development.

The majority of organizations involved in HIV/AIDS in Tanzania are using a health approach to programming. Due to the taboos surrounding sex and sexuality and the social stigma, and negative perceptions on bodily integrity, most organizations have yet to adopt a clear Rights Based Approach framework to their programming.

While a number of organizations recognize that a more holistic approach is needed to advance HIV/AIDS, most of the interventions being used are still very conventional and often ignore the rights of marginalized groups like women who are being trafficked for sex; women who are forced by society to marry brothers in law when a sister dies, most often from AIDS related disease; wives in a polygamous household whose husbands marry second, or even third wives, without taking the necessary precaution of having them tested for HIV; survivors of rape who are not only told it is necessary to report the rape to law enforcers, but they are also not informed that they need to have a pregnancy test, and, a test on HIV!

It is also important to note that the majority of organizations engaging in this agenda, only began to do so in the last 5 years, are operating at a relatively small scale, and are still in the process of developing their own theories of change and home-grown strategies to address Key Populations in the context of girls/women in forced marriage; survivors of rape; girls/women who are being trafficked in sexual exploitation; in relation to HIV/AIDS in Tanzania.

It has to be acknowledged that tradition; religious orientation and patriarchy often shape the mainstream’s perception of sex and sexuality which in turn influences the mainstream definition of what constitutes Right and Wrong; what constitutes Moral and Immoral; what constitutes Modern and Traditional; what constitutes Social and Cultural norms.

For example, various ethnic groups in Tanzania feel it is a moral obligation on a young woman to marry her brother in law even if her sister died from AIDS related health complications, and the brother in law is most likely a PLHIV. Society would demand that the young woman marry her brother in law in order to take care of her deceased sister’s children; in order to ensure the union of the two families is not broken; in order to ‘save’ her family from having to return the bride price which was given to her parents by the husband and his family, when her late sister got married.

Another example is when an older brother dies from AIDS related health complications, leaving behind a widow and small children, and a younger brother is expected, and sometimes forced to inherit the widow and children, even though such a commitment would place the younger brother at risk of getting infected with HIV, but since time immemorial, communities in Tanzania have adhered to such a practice, with good intentions mind you, that of protecting the widow and her small children, but when taken in the context of HIV and AIDS, it becomes tremendously unfair to a young man to inherit the widow of his late brother, the brother who had died from AIDS related complications.

Suzanna is one such widow who was put in the most embarrassing situation of being forced to marry her brother in law, three months after the death of her husband.

Suzanna is a woman in her mid 40s while her brother in law is a man of 38 years of age. The fact that she had given birth to five children, four sons and a daughter, has given her status in her late husband’s family. Her late husband’s family refers to her as ‘The mother of four lion cubs, meaning the four, healthy sons she had given birth to with her husband.

She categorically refused to marry her brother in law, citing the age difference and that she had always looked at him as a son; apart from the fact that she is a PLHIV and it would be most unfair to Jeb, her brother in law, who at that time was in love with his girlfriend and he had confided to Suzanna that he would propose marriage to his girlfriend the moment she graduated from university.

Her late husband’s family then informed Suzanna that she would have to go away, from her children; from her home which she and her late husband had lovingly planned and overseen the construction; return a quarter of the bride price given to her parents 20 years earlier when she got married; stop using their clan name; and most of all, cut off all contact with her children.

Suzanna decided that taking the matter to court should be her last option. She then went to see the Anglican Bishop of her diocese with the medical card of her ART treatment to boost her immunity because she is a PLHIV and informed the Bishop of the harsh stance taken by her late husband’s family. She also informed the Bishop that her brother in law who was being forced to marry her is not a PLHIV, and that it would be grossly unfair to put his life at risk.

The Church intervened and Suzanna has custody of her five children; the ownership of her house which she is keeping safe for her children; she is using the clan name of her late husband with the full status of being a daughter in law of the family. She even got to participate in the wedding of her brother in law and was treated like the esteemed daughter in law, a status which is most important to her.

Owing to the fact that many of the initiatives of the past have failed to adopt a more inclusive approach in HIV/AIDS Intervention, most initiatives are now focusing on reducing vulnerability to HIV, AIDS and STIs, without focusing on increasing access to proper medical and sexual Health Services, and providing technical support to groups which are mainly invisible in the HIV Intervention planning processes, whose Voices are Hidden in the HIV and AIDS agenda, and which would give such marginalized groups like young women who are trafficked in sexual slavery, which places them in the vulnerable position of not being able to negotiate for protective sex.

Bahati is a girl who is a victim of trafficking into sexual slavery by a woman brothel owner who had ‘bought’ from a ‘supplier’ of underage girls, minors, and girls below the age of 15, who are taken away from their natal villages in rural communities, brought to cities in Tanzania, and sold into sexual slavery by human traffickers.

These minors who are being sexually abused by the brothel owners; and by the pedophiles who pay the brothel owners for sexually abusing the girls, children really, are the ‘hidden’ group in the Key Populations agenda.

Until six months ago, they were called sex workers until feminist activists pointed out that these little girls are NOT sex workers. They are in fact, little girls who get defiled by pedophiles who pay money to human traffickers for the defilement.

As a nation, we do not yet have a program to address the HIV Intervention of these little girls, simply because we cannot face the grim reality that these girls need to be rescued from the clutches of the girl traffickers so that they would lead safe and secure lives of being in school; of having protection by parents, society, and law enforcers; of being normal, happy, little girls, instead of being dressed in scanty clothing, made to wear garish make up, walk in high heels, and get sexually abused by pedophiles.

We do not know the number of such girls who are being exploited by human traffickers and pedophiles. The few girls this writer spoke to while doing a survey said they would get beaten and maimed if they made the attempt to run away from their jailors.

The police charge them with loitering or prostitution, because they get caught while looking for punters so they would get paid money in exchange for being sexually defiled because their traffickers expect them to bring in the money on a daily basis, otherwise, they get beaten by thugs who are in the pay of the trafficker.

These little girls need rescue and rehabilitation. They need to be given opportunity for education. They need to be affirmed that what they have been doing is not their fault. That they are the victims of criminals who prey on little girls by paying the girls’ parents some cash with the promise of finding them employment in cities, then are sold into sexual slavery.

The law, the Sexual Offences Special Provisions Act, SOSPA 1998 is quite explicit on child defilement. What the punters, the buying of sex from the little girls is in fact, child sexual defilement which carries a penalty of life imprisonment. The law SOSPA 1998 should be enforced to save the little girls, while the Anti Human Trafficking Act 2008 should be enforced to serve severe penalty on the traffickers.

What needs to done

• Local Government Authorities LGAs need to be sensitized to be able to spot little girls who are being sexually exploited by human traffickers; and by pedophiles.
• Parents of little girls in rural communities should be informed through community radio stations; by their LGA Chairmen; by their Councilors; by their Members of Parliament; and by their religious leaders about human trafficking, and that they should not ‘sell’ their daughters into sexual slavery and bondage, when some smart, well dressed come to their villages from cities and urban on the pretext of recruiting domestic workers.
• Communities should be informed on the outdated tradition of wife inheritance, not only because of the HIV factor, but it is also a violation of Rights when a person is forced to marry against their wishes.
• Families need to discuss HIV and AIDS as a health and social agenda when they interact as families. This would create a sense of responsibility among family members to take precautions on HIV infection, as well as to show support and compassion to PLHIV who are part of a family.
• Communities need to be sensitized on pedophiles. This can be done by CSOs with support from law enforcers.
• Rescue and Rehabilitation of little girls, and sometimes of little boys, who are being trafficked to pedophiles ought to be taken up as a priority agenda by Faith Based Organizations; by Human Rights CSOs; by Law Enforcers; by LGAs; by MPs; and by the entire Tanzanian society.

“Together We Can Make it Happen”

Leila Sheikh