Aids creeping into a community still in denial

Joyce Chimbi

Life has not been the same since she lost her parents four years ago. Her immediate relatives grabbed the little property the family owned thus aggravating her already sorry state. Each day since has meant living for herself and her two younger sisters.

Having no property and no education, 22-year-old Fatima Hassan took the advice of her best friend, Amina Ahmed, and the duo began a journey that has transformed her life forever. They sell their bodies to make a living. (Their names have been changed, though, because if known to the community, their newly acquired lifestyle could lead to dire consequences, even death).

It has been four years now and though Fatima admits the experience has scathed her, she believes it was the only way she could provide for her siblings. "I have been subjected to all manner of abuse, both physical and sexual. But I could not stop, I did it for my sisters," explains Fatima with a distant look on her face.

"I know they are aware of what I was doing, but I was able to provide for them, and constantly warned them of the repercussions of what would befall them if they followed in my footsteps".

Her body is fully covered in accordance with the Islamic tenets, revealing only her face — one that is devoid of all expression and emotions. She narrates how, together with Amina, they sunk deeper and deeper into the world of prostitution, a world she is now fighting to leave and which has given her a permanent mark; a child.

She speaks almost in whispers, pausing every now and then to ensure that there is no chance of someone else eavesdropping on the conversation.

Although the Muslim community is still very much in denial, their young girls continue to flirt with the dark world of prostitution and this, among other factors, has put the Mandera, a region in Kenya’s North-Eastern Province on the high-HIV-prevalence map.

In 2003, no HIV cases were recorded in the province, yet the same cannot be said now. According to the Kenya Aids Indicator Survey (KAIS) 2007, there is now a 1.3 per cent HIV prevalence in the region.

The figures might seem small in relation to the current 7.1 national figure, but in a region with an estimated 312,000 people and with a previous 0.0 prevalence, it is clear that HIV is slowly creeping into this region.

Persistent denial

This problem comes against a backdrop of persistent denial that HIV is a problem among the Muslim community.

Mandera is a strong Muslim district that borders Somalia, which is also almost all Muslim. Somalia is a country that is also feeling the challenge of the Aids crisis.

Three years ago, studies revealed the national HIV prevalence in the Horn-of-Africa-country was a paltry 0.2 per cent. But, according to a recent study, the figure has risen to 1.9 percent.

"It is very sad that the Mandera community is still in denial with regard to HIV, yet the region is within an environment that is very conducive to the spread of the virus," says Amina.

"As you can see from my story and my friends here, prostitution is an issue; sex out of marriage is also common, although we do it very discreetly."

Hassan Isaack, a community worker, echoes her sentiments. "Things are slowly changing in Mandera, and there’s need for a change in thinking and in the way we approach the HIV issue because people are getting infected," he says, adding: "Furthermore, Mandera residents are a polygamous community. There’s also wife inheritance, young girls getting married to old men and a growing trend of sex out of marriage. So how can HIV not be an issue?"

Women at higher risk

According to the Kais study, women aged between 15 and 64 are more likely to be infected than their male counterparts in the same age bracket and they are even more at risk if they have less education.

Women of a high level of education who are pursuing a career are the exception in Mandera. In fact, they have for a long time been regarded as faithless.

"The community frowns at the educated woman. If you put the educated career women together with the uneducated, the dichotomy is quite clear. But we are slowly working against these misconceptions," says Halima Abdalla, a local community worker.

Education and a source of income enable women to make key choices that they otherwise wouldn’t make.

"It is natural to have these pockets of denial in Mandera, but we cannot afford to be complacent, " Isaack says, asserting that the community needs to face reality because Aids cannot be wished away.

Although HIV prevalence is low in Muslim communities because of the strong religious beliefs, it is an issue that is now calling for urgent intervention.

"What is now evident among the Muslim community is that a imminent evolution of Aids is taking place despite the denial around the disease. The community has had to change its approach," explains Dr Otieno Nyunya, a Nairobi gynaecologist.

Dr Nyunya adds that the situation in Mandera scenario is replicated in many other places across the globe.

"Take Asia, for instance, where there is a strong wave of denial regarding Aids because, just like in many Muslim communities, Aids has arrived late," explains Nyunya.

However, the medic says that the district is in an even more precarious position with regard to Aids because of its geographical position.

Hub of diseases

Not only is it a rural district, in which the greatest prevalence of the disease is generally recorded, according to the Kais study, but the fact that it borders Ethiopia and Somali makes it a hub for the burden of infectious diseases, including Aids.

"Cross-border travel and/or transition puts the community in question at a higher risk with regard to HIV than other communities who don’t have these activities," says Nyunya.

"It’s common along the Kenya-Uganda, Kenya-Tanzania and Mexico-United States borders, which is all the more reason why the Mandera community requires interventions that will keep the Aids prevalence as low as possible."

Although these interventions are vital, the negative perception of Aids in Mandera and the general belief that it is a non-issue pose a great challenge to the residents and the authorities.

The community strongly believes that the disease is for people who are weak in faith, and that because of early marriage, which is the norm in this part of Kenya, it cannot thrive.

In fact, whereas early marriage is a tradition that is frowned upon in many parts of the country, and seen as a harmful cultural practice, the Mandera community embraces it as a solution to the Aids infection.

This, therefore, is one of the factors that if not addressed with the urgency that it deserves, will become a catalyst to the rise of Aids in a community that in 2003 had a 0.0 per cent prevalence.