Survival on Lies: Do People Living With HIV/AIDS have to lie on their Serological Status to avoid Stigma?

A few weeks back  I listened attentively to ‘SOS Doctor’, one of the best health programs that be on Radio in Cameroon. As I listened, I got very happy at the great job that Dr. Dion Grace, a member of the National AIDS Control Committee of Cameroon was doing to educate Cameroonians on anti-retroviral drugs. She eloquently and insightfully answered every one of the questions that were posed to her by listeners who called-in and am sure her intervention in the program was a timely one. Everything was fine until when a listener called-in to ask what is it that could be done to reduce stigma on people who are on anti-retroviral drugs. Dr. Dion as usual gave a very insightful answer to this question going as far as citing the example of Ivory Coast where the drugs are put in anonymous packages so that they can be taken by patients without fear of stigma by the people around them. She went ahead to cite cases where some special containers of various doses is been used in some countries to reduce stigma. This was quiet interesting to know, but when she started advising people on anti-retroviral that they could tell people around them that they are taking vitamins or pills in order to avoid stigmatization I grumbled the following to myself: Do I have to be so ashamed of my status that I have to lie to others?

I have no statistics on this but I can assure you that having to lie on your HIV status is the order of the day in Cameroon especially amongst young people to avoid stigma and discrimination.  Well, this to an extend is understandable given that People Living With  HIV/AIDS(PLWHA)  are considered as being punished by God for either their sisns or those committed by their family. But when telling a lie to avoid stigma is a behaviour that is reinforced health professionals, I have reservations and clearly doubt how efficient this approach could be.

I am utterly convinced that a problem can only be solved if its root cause(s) is/are carefully tackled. As a young person living in a society where most PLWHA are young persons, I compare telling a lie on your HIV/AIDS status to survive to deliberately refusing to tackle the problem from it’s source and launching an attack on its leaves instead. 

"1200 000 People Died of AIDS in Africa in 2011. Millions of  these deaths being avoidable", says this bill board, at the heart of Douala-Cameroon' most populated city

 

 To reduce stigma in the most sustainable way possible, education rather than lies is required.Young  People, their families, and the communities in which People on anti-retroviral drugs have to be educated on the dangers of stigma and on the importance of accepting PLWHA. Ban Ki-moon, the United Nations’ Secretary-General,  vividly spelt out society’s responsibility to PLWHA when he declared that,  “We can fight stigma. Enlightened laws and policies are key. But it begins with openness, the courage to speak out. Schools should teach respect and understanding. Religious leaders should preach tolerance. The media should condemn prejudice and use its influence to advance social change, from securing legal protections to ensuring access to health care."

 

Lies do nothing but contribute in amplifying the myth around HIV/AIDS in the Cameroonian society. People on anti-retroviral drugs do not need to lie on their status to survive stigma, they need to accept themselves as they are and deserve the care and protection that every other human being is due by the society in which they live.They deserve to live a real life and not a life of lies.

Marrying at 15 is her Greatest Regret

In Cameroon, taxis and other public transport have become the place where Cameroonians most enjoy discussing political and social issues. And so it happened a few weeks ago that I boarded a Taxi whose driver did not stop telling people of the disgust he had for parents who send their girls to school.

‘At 14, when my daughter passes her BEPC(GCE o level), I send her to school for two more years to go and ‘waste time’ so that she reaches 16 and I give her out to a man for marriage. No girl in my home aged 16! Her husband’s home is where she belongs’, said the driver proudly with the tone of his voice revealing how convinced he was of what he had just said.

I looked at him with anger and then thought of the many girls whose lives have been ruined by selfish and inconsiderate decisions taken by their parents to get them out of school and ‘ hand them over’ to their so-called husbands. Furious at the sayings of the driver, I could not help but think about Linda (not her real name), whom I met some years back.

Linda, like 36% of girls in Cameroon, was a victim of child marriage (UNICEF). She hails from one of Cameroon’s rural communities, which account 23% of the cases of forced marriages in the country (UNICEF). Linda dropped out of school in form three (third year of secondary school) 10 years ago following pressure from her parents to marry a man, 20 years older than her, and whom she had never met. Bowing to her parents’ pressure she thus forfeited her rights to education, her rights to choose to marry whom she loves, and her rights as a child.

MARRYING AT 15 YEARS IS LINDA's GREATEST REGRET

Having no choice in the face of this decision taken by her parents, at 15, Linda’s dreams of becoming a Doctor were thus shattered. Today, Linda is 25 , has 3 children whose upkeep is sole dependent her, has become the bread winner for her household, and regrets having giving in to the pressure mounted on her by her parents to get married to this man for whom she has become a child bearing instrument and sole provider.

The 1948 Universal Declaration of Human Rights states that marriage should be ‘entered only with the free and full consent of the intending spouses’. Going by this definition and taking into consideration the stands of the Convention on the Elimination on All Forms of Discrimination against Women (CEDAW), which holds that children below 18 years should not be allowed to get married because they do not have full maturity and capacity to act, one will have every reason to stand against child marriages-any union in this circumstances will be considered as forced marriage.

But according to Plan International, an international Non Governmental Organization (NGO), ten million girls under the age of 18 marry each year. Still not moved? The above figure implies that:
• 833,333 girls under 18 marry each month
• 192,307 girls under 18 marry each week
• 27,397 girls under 18 marry each day
• 19 girls under 18 marry each every minute
• Around 1 girl under 18 marries every three seconds

Despite the fact that all sub-Saharan African countries (except Somalia) are signatories to the Charter on Rights of a Child, Sub-Saharan Africa has the second highest rate of early and forced marriage (38%) according to statistics from the above mentioned NGO . 14.3 million girls in this region are married before they reach 18. Studies show that the average age of marriage in this region remains among the world's lowest and the percentage of adolescent mothers the world's highest.

CAUSES RANGING FROM TRADITION TO POVERTY

In Cameroon, child marriage is most prevalent in rural areas, where poverty , traditions, ignorance of the law, and illiteracy still reign supreme . These include traditional, religious and cultural practices which continue to treat women as commodities and inferior beings that have little or no role to play in their communities and are good only for the kitchen.

Also, the prevailing poverty in rural areas makes the girl the only realistic potential source of income to parents. They thus arrange marriages for these girls and charge a bride price that will enable them buy food, and other household commodities. This may also be to pay back money borrowed by a parent who cannot repay and so gives the daughter in the place of payment.

CHILD MARRIAGE: A WICKED PRACTICE

The negative effects of early marriage in my community go beyond just the girls concerned and affect the children they give birth to. Thus low weight babies and a high rate of morbidity among children born by girls in forced marriages is very common.

Young married girls are more often than not victims of Ve sico Vaginal Fistula (VVF). VVF is incontinence of the bladder which allows the patient to pass urine indiscriminately. VVF in arises in cases of forced marriages because of the very tender age and immaturity of the sexual organs of the girls who are forced into these unions.

Also , young married girls are exposed to: mental health effects, the hazards of contracting HIV/AIDS and STIs from their older husbands and above all to unwanted pregnancies, Premature births, and other pregnancy-related complications which at times take away the lives of these young girls. In fact, in low and middle income countries, childbirth is the #1 killer of young women between ages 15 and 19.

POLITICAL WILL IS NOT ENOUGH TO END CHILD MARRIAGES

I very much agree that political will, the voting of laws that prohibit child marriage, the equitable distribution of resources to its citizens to mitigate the effects of poverty and reduce illiteracy are needed to put an end to child marriages in Cameroon. But I am more than convinced that a more accessible, affordable, conducive, and above all inclusive educational system is needed to effectively fight against forced marriages

The educational system in rural areas is a great push factor for early marriages in Cameroon. Gender based violence(GBV), poor infrastructure, gender bias teaching material(text books), cultural practices which discourage parents from fully investing on the education of women, and a non-conducive learning environment are all motivating factors for girls to drop out of school. Hailing from a rural community, I have observed that most girls who drop out of school have marriage as a main option. Thus, education in rural communities should be made not only more accessible and efficient but also more welcoming to girls.

To guard against the consequences of child marriage, girls must be protected against traditional and religious practices that enslaves and traumatizes them. So that, unlike Linda who is today a roadside roasted maize seller, they all achieve their dreams of greatness in this world. All girls have the right to live happy and fulfilled lives, don’t they?

This blog can also be read at:http://www.amplifyyourvoice.org/u/Gastonkwa/2012/4/23/Marrying-at-15-is-her-Greatest-Regret

Respect Us! Give Us Opportuniy, Not Charity

Fighting HIV/AIDS and other diseases like malaria is one the Millennium Development Goals(MDGs) voted by the United Nation’s in the year 2000. Given that this fight seems to be slowing down and that more than 5% of Cameroonians are living with HIV/AIDS-60% of which are women and 40% falling in the youths category-there is a cause for concern on the strategy to be used for the achievement of MDGs.

Conscious that handicapped persons are also celebrated in December and given that living with HIV/AIDS is more and more considered a handicapped. This article is going to dwell on the inclusion of the handicapped in the achievement of MDGs.

Concerning the non-achievement of the Millennium Development Goals (MDGs) by most countries of the global south, much has been said and so much more left unsaid. But if there is one thing that has so often been ignored by policy makers, politicians and all those in charge of implementing policies that will lead to a timely  achievement of MDGs, it the absence of human rights in these goals. The non-inclusion of human rights in the MDGs means the exclusion of handicapped persons, indigenous people, and other minority groups in their achievement.

Given that handicapped persons constitute 10% of Cameroon’s population and are among the poorest people in the country, it is evident that talking of poverty, the fight against hunger, improvement of maternal health care and reduction of infant mortality child is pretentious if nothing is done to the more than 85% of these handicapped persons aged14-64 years who are jobless and the other 15% of them who are confined to shoe mending, shoe shinning and other informal sector activities.

Also, talking about achieving universal access to education without paying particular attention to the fact that less than 5% of handicapped children in Cameroon can afford to

go to school with only 2% of these handicapped children completing secondary school, is wishful thinking.  What about the  ever increasing number of albino children who because of their sight defect and the inability of their parents to buy them glasses drop out daily from school?

The government of Cameroon recruited 25000 certificate holders in 2011 under a special recruitment scheme. But none of them was an handicapped person and as if this was not enough, a good number of handicapped persons were sent away from public schools because they could not afford to pay the required fees.This despite the fact that they are officially exempt from the payment of school fees in public schools in Cameroon. To protest against the above acts, the handicapped organized a protest march in front of the prime minister’s office in October 2011 but were violently dispersed by the police and military forces.

Can we say of a country whose government carries out such horrible acts against its own very population, even if it achieves all the MDGs, that it is developed? Can MDGs be achieved if the strategy to achieve them is not inclusive? Can the achievement of MDGs, as they are now, lead to sustainable development?

My answer to the above questions is ‘NO’. Because I am intimately convinced that, unless inclusive and people-centered, no development plan can produce any sustainable results. It is high time for our government and civil society to listen to and amplify the voices of the handicapped so that they are heard and acted upon by policy making and implementing structures because like all poor people, “they long to belong to, and participate in their communities on equal footing with others. Most of all, they do not want charity. They want opportunity”, as former world bank President James Wolfehnson once put it.  Anything short of this will make the achievement of MDGs in Cameroon, even by 2035, a far-fetched dream.

How can one expect a country like Cameroon to achieve the MDGs related to literacy, health, and economic empowerment when it does not take the handicapped into consideration when designing and constructing public buildings and other infrastructure like roads, hospitals, universities, and schools?

How can one expect Cameroon to be democratic,united,and emerging by 2025,as exposed in its vision 2035,when more 10% of its population(handicapped persons) are disenfranchised due to their non-consideration when designing and producing electoral material(especially ballots) and situating polling stations(Most being inaccessible to the handicapped)?

Realizing that the above is impossible without respect for human rights, we, at the Education 4Development Foundation (E4DF) have made human rights the 9^th MDG and therefore one of the elements of our advocacy and awareness creation campaign on a participative,timely, and inclusive achievement of MDGs in our community. Through our MDGs participative achievement programme, we reached out to more than 1000 pupils and students in 2011 and look forward to reaching out to a greater number in 2012.