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February 5-9 , 2004, Dar es salaam, TANZANIA |
Accepted Abstracts OnlineSummary, Abstracts
0P 01: Acting for Television Drama in
Tanzania: An income generating activity? Issue Tanzania is one of the developing countries whereby the hidden agenda behind the high spread of HIV/AIDS is unemployment and underpayment. Youth in Tanzania have been in the forefront to struggle for better life. Through their creativity youth have involved themselves in different activities so as to earn a living.Television is one of the popular medium in Tanzania. It brings attention not only to youth but also to the entire community. Among popular television programs is drama. The production of television drama needs not only talent but mostly expertise. Because of less expertise, inexperience and lack of knowledge about the whole process of television drama production, greedy producers, promoters and directors have victimized the artists especially young girls in the spirit of giving them popularity and promotion. Some of male producers, promoters and directors have been in the forefront in intimidating and violating young girls’ rights. Without concrete reasons, they underpay or sometimes do not pay them at all. Some girls are forced to have sex so as to appear on the television screen, and in most cases it is unsafe which leaves them in a high risk of getting HIV, STI’S and/or unintended pregnancies. Conclusion Having less expertise and experience in TV drama production, as an actress does not mean one have to fill the gap by providing forced sex. Recommendations TV actresses need empowerment so as to recognize and defend their sexual rights. TV drama producers, promoters and directors should opt (willingly) not to molest young artists, rather build their capacity to become future independent and experts actresses, producers and directors. 0P 02: Tuseme (Let’s Speak Out) Process: An
ideal youth’s intervention methodology Background This paper advocates for the use of an ideal methodology during youth’s HIV/AIDS intervention. One of those methods is Tuseme Process, which is also commonly known as Theatre for Development (TFD). TFD can be regarded as theatre of the people, from the people, to the people, by the people. It is also known as Community Theatre, Popular Theatre etc. Objective To design and develop feasible and sustainable interventions, which will give youth a spirit of behaviour modification. Methodology Tuseme Process is a methodology whereby youth are involved from the beginning of the research to intervention session through theatre creations. The whole Tuseme Process is basically edu-entertainment. With the help of a facilitator and role-playing, youth identify problems (e.g. condom use, stigma, sexual violence, risk behaviours etc.) trace its root cause and value the magnitude of the problem. Through post performance discussion, youth set an action plan which suggests possible solutions, responsible individuals and time frame for suggested implementations. Results Increased voluntary youth participation in planning and implementing relevant intervention in relation to time, community and lifestyle. Recommendations Organizations and individuals who are dealing with youth HIV/AIDS interventions should use bottom-up approach rather than commonly used up-bottom approaches when advocating for youth’s behaviour modification in relation to HIV/AIDS OP 03: We should respect for the Human
Rights and Dignity of affected by HIV/AIDS Even though the HIV/ AIDS affects all levels of the population, poverty is in fact a close companion of VIRUS. Since 1996 our Forum has been organizing women’ s group with the collaboration of World Asian Workers Organisation (WAWO) to perform their duties to create the awareness among the workers and their wives on AIDS, Forum is also providing some literature amongst the workers on HIV/AIDS and every effort is being made to include the women in the decision making needs assessment, program planning to safe the human being from this disease. In the spirit of Nobel cause we should respect for the Human Rights and dignity of those persons who are affected by HIV/AIDS and there should be no discrimination and stigmatization against them on the bases of perceived HIV status. There should be no discrimination against them and their dependents living with HIV/AIDS. Important points Strengthen the response to HIV/ AIDS by establishing and implementing prevention and care programs in public private and informal work sector and take measures to provide a supportive workplace environment for people living with HIV/ADIS; Develop and implement national, regional, and international strategies that facilitate access to HIV/AIDS prevention programs for migrants and mobile workers including the provision of information on health and social services; Implement universal precautions in health-care settings to prevent transmission of HIV infection; Review the social and economic impact of HIV/AIDS at all levels of Society especially on Women and the elderly. In a word I would believe that people with AIDS need a really good support system. Be it from friends and family or counselors to help them to deal with this dreaded disease. They need medication to help slow down the disease's progress. They need people to be educated about this disease as well as people living with AIDS need to be educated as to what they are about to go through with battling this disease. I think that people with AIDS have the right to have affordable medication for them, the right to live their lives as they choose fit instead of being discriminated against. OP 04: To explore situations which succumb
young girls to HIV/AIDS/STDs, early pregnancies Background According to Ministry of Health Surveillance Report June 2003, 15 – 19 year youths make up the highest number of HIV infected people in Uganda. In view of that factor, one adolescent counselor and one ASRH Specialist attached to Straight Talk Foundation Uganda carried out a baseline survey in 3 secondary schools to assess the exceeding HIV/AIDS pregnancy rate among this age group. Methods The tools used to gather the required information. Results The following factors were realized to pre-dispose the girl child to HIV/AIDS/STDs early pregnancies Peer group pressure, Female cultural submissiveness, Poverty, Alcoholism/drug abuse, High rate of defilement Forced early marriages, Idleness, Greed for money, Cultural gender inbalance ,Sugar daddy phenomenon ,Trans-night ceremonies, Pornographic films/magazines Conclusions In view of the identified situations, it is a worthwhile venture to sensitise youths in and out of school to adopt life skills like assertiveness, critical thinking, non-violent conflict resolution, decision making, self esteem, self awareness, effective communication, negotiation skills in order to avoid risky situations within their sexual reproductive health. OP 05: Appropriate Youth Friendly Intervention Programmes: “REACH OUR MINDS” Chris Zela Mudenda, University of Zambia, secretary general, Rescue mission Zambia, DOSA, P.O.Box 32379, Lusaka, Zambia. chrismudenda@yahoo.com Many youths are naïve towards life experiences. They, by default have encountered less painful moments, solved less problems by themselves and seen less than what the old folks have been through. This ‘lifetime gap’ is a pool of anxiety and hunger to ‘taste’ and experience any new ‘stuff’ that comes their way! In Africa and Zambia for instance lack of sufficient recreation infrastructure and a complete set up of other youth targeted intervention programmes has led to the increased vulnerability of the youth to the natural ‘game’ of sexual indulgence, especially in the rural areas where choice of activity is far less. In urban areas the dominating activities have been those that encourage or perpetrate the sexual behavior by bringing the force of sexual desire close to the mind of the youths. Events such as daily night discos and parties as well as other related activities have been centrifugal points for the AIDS VIRUS. Many such arenas even come in handy as the industrial bases of prostitutes who linger as core and peripheral vultures. Even the little income generated by some youths is spent carelessly at such functions as it’s used as a vice to show others their potency. Amicable introduction and set up of deliberate programmes would help a great deal by reaching and capturing the mind of the youth. Deliberate or appropriate programmes can have a turn-point factor for the youth. More sporting activities and other strategic programmes would be a force for change for the youth! (249Words) OP 06: Using Performing Arts for ASRH messages for Youth Peter Masika, Director of Tanzania Youth Aware Trust Fund (TAYOA), Tanzania Youth Aware Trust Fund (TAYOA) an Implementing Partner of African Youth Alliance (AYA). Learning Objectives This presentation will demonstrate the value of performing arts in ASRH interventions, targeting out of school youth in Tanzania and Africa in general. The strategy had helped more than 33,700 youth in Dar es Salaam, Tanzania to acquire responsible behaviour under African Youth Alliance programme and PATH’s stages of Behaviour Change Communication. Background Performing art is an essential tool to mobilize, reach, sensitize and educate larger groups of youth on various issues related to ASRH. This has greatly help Tayoa in moulding, and change behaviours of out of school youth in three Districts of Dar es Salaam, build self esteem, equip them with necessary skills and knowledge on ARSH, and how to prevent themselves from the threats of HIV/AIDS, rape, sexual harassments and related problems. Basically, performing arts activities under AYA projects involved different ASRH promotion community outreaches like drama, choir, traditional dances, rape musics, poems, safari games, video shows, public matches, role play, sports and ASRH talks. Through such performing arts, youths peer educators took ASRH objectives to a larger and wider audience. They also planned, organized, and implemented many festivals and health awareness raising activities within their groups and communities. Methodology and Results TAYOA through AYA-funded by Bill and Melinda Gates Foundation for ASRH programme had recruited, trained, supported over 3370 youths ASRH volunteers (Peer educators and Youth ASRH Promoters) in 27 Wards from across three districts of Temeke, Ilala and Kinondoni, Dar es Salaam-Tanzania in the last three years. Using outreach performing arts activities, the trained youth ASRH volunteers have managed to reach and reported back, at least 10 youth each, adding to 33,700 young people, boys and girls. In the year 2002 alone, we recorded a youth ASRH rap music CD, which was used by peer educators. They conducted several performance and reached about 12556 youth, with designated messages such as condom negotiation skills, abstinence, faithfulness to single sexual partner. Under a three-year ASRH programme, TAYOA also organized 26 youth performing arts festivals, which involved over 500 youths and other community members each, from different Wards of Dar es Salaam. These festivals largely carried ASRH messages including unwanted pregnancy, HIV/AIDS, Sexual Transmitted diseases (STDs), drug abuse, rape, harmful traditional practices, gender equality, youth leadership etc Conclusion Despite the fact we have reached wider youth community through performing art activities, some conservative parents still against ASRH programs on grounds that strategy promotes sexual activity. Although sensitizing communities on the need for parent-child communication is extremely demanding and time-consuming task, but it is crucial if the ASRH on Behaviour Change Communication for youth is to succeed ideally. So, we have designed a more efficient way of doing it through performing art activities from our three-year experience. OP 7: Hospice Care Grey Saga, Sokoine University of Agriculture, P.O.Box 3214, Morogoro, Tanzania. gresir@yahoo.com Hospice care is a specialized nursing treatment for people with terminal illness. In most countries there are now a number of people with HIV/AIDS and its related terminal illness. According to ARHTAG 1995, long-term hospital care is rare needed for people with terminal illness though it may be necessary for some special investigation and treatment or intensive nursing care. Hospice care plays an important role in minimizing the impact of HIV/AIDS. But the impact of HIV/AIDS is not only to the sick member, but the entire family in which children are most vulnerable. Though children affected by HIV/AIDS are recognized as major sector of needs by TACAIDS, they receive limited attention and services. Like many other programmes, Hospice care do not focus on children. If the guardian can no longer care for himself, the child is neglected. Conclusion Due to limited financial resources, helping the sick and their vulnerable members from a single project may be difficult. Though the use of funds is necessary for prevention and treatment, if we are to really minimize the devastating impact of HIV/AIDS to these families, support of the vulnerable members becomes an important component in projects and programmes. Recommendation There is no need to start new programmes, based on observations during the study, it is important to complement the already existing, but financial constrained projects, small projects may be started to complement the existing ones, Support to foster parents and orphaned children is necessary in Hospice care which only focuses on patients with terminal illness. OP 08: FORMAL EDUCATION AND AIDS Achieng Osong, Kenya. I once got an opportunity to discuss HIV/AIDS with some form four leavers at a leaver’s party and was a bit disappointed when the discussion could not go beyond the synonym in full, the ABCs and that AIDS kills. Social Education and Ethics (SEE) has been scrapped off the Kenyan syllabus at a time when AIDS has been declared a national disaster. Formal education is that we are taught in class and although it has been criticized on many occasions that it is only theoretical, it goes a long way in shaping character. It forms the basis of how people interact in society. It is on this premise that HIV/AIDS should be incorporated in the formal curriculum. Subjects like SEE should be taught early enough so that students grow up knowing what society expects of them, what behavior patterns are acceptable and explanations as to why they should behave in one way as opposed to another given. Then the issue of HIV/AIDS can be brought on board after behaviors have been shaped. It is not enough to teach about HIV/AIDS without incorporating disciplines like SEE, religion and other social sciences. Much as AIDS in people’s lives, maybe if it was mentioned over and over again and students made to sit exams on it they would remember and maybe live up to expectations and this would create awareness, solve stigma and discrimination and most importantly bring about behavior change.
OP 9: WHY YOUTHS NEED AN HIV/AIDS POLICY Chilambe Katuta, University of Zambia, P. o. Box 32379, LUSAKA. ZAMBIA. Phone: +260-097-763-543, Email: chilambe@zambia.co.zm ISSUE: Youths of today are a diverse group, and their diversity must be taken into account when planning HIV/AIDS policies. It is without a doubt that the Youths are the most vulnerable and indeed most infected and affected by HIV/AIDS. However, is sad to note that the Youths are not given the opportunity to take part in high level decision-making. Because of the above and other compounding factors it is important that the Youths have an HIV/AIDS Policy that will take care of their interests. CONCLUSION: So in order to create an effective working HIV/AIDS policy for the youth. The Policy must first encourage youth ownership and participation, the policy must work to end the silence, stigma, and shame amongst the youth concerning HIV/AIDS. Provide young people with knowledge and information and mostly equip young people with life skills to put knowledge into practice. RECOMMENDATIONS: Why Youths should be involved in creating their HIV/AIDS Policy for the youth. Youths are the most infected and vulnerable. Youths can ensure relevance of programs to young people actual needs. Youths can play an important part in pointing out the messages, communication channels and activities popular with their sub culture
OP 10: PICTURES OF STIGMA: CHILDREN’S EXPERIENCES OF HIV-RELATED STIGMA IN ZAMBIA Lawrence Mwenge, University of Zambia, P. o. Box 32379, LUSAKA. ZAMBIA. Phone: +260-097-763-543, Email: L_mwenge@yahoo.com Background A study to explore children’s experiences of stigma in urban and rural settings in Zambia was conducted as part of a larger multi-country research initiative on HIV stigma and discrimination. Methods Four groups of children were identified in urban and rural communities: school-attendees, street children, non-school attendees, children living with HIV or TB. and individual interviews carried out by child counsellors. The children were followed up after the research by the child counsellors. Triangulated, qualitative data underwent structured text analysis. Results Different types of HIV-related stigma were faced by different groups of children. The stigma of being an orphan cuts across all groups, with orphans acutely aware of being treated differently to the family children e.g. given more work, less food, no school fees. Girls are more vulnerable to stigma and becoming involved in risky sex. Conclusions/Recommendations There is a need for greater adult awareness and understanding of children’s experiences. Access to psychosocial support for children, especially on loss and grief, should be enhanced. Education is needed for all children!
OP 11: PLWHA EXPENDITURE IN SIAVONGA DISTRICT, SOUTHERN ZAMBIA. Moonde Kabinga, University of Zambia, P.o. Box 32379, LUSAKA. ZAMBIA. Phone: +260-097-767-101. INTRODUCTION: This paper reports on People Living With HIV/AIDS (PLWHA) expenditure on their nutrition and health. It has been stated PLWHA should get good nutritious food and clean water at all times. The food should be rich in protein and vitamins, which help the body, fight off opportunistic illnesses. METHODS: 57 individual interviews of PLWHA was conducted in Siavonga District. A structured questionnaire was administered to the respondents. Respondents were asked about their general expenditure on HIV/AIDS. e.g. how much they spend on their food, buying medical drugs to treat off opportunistic illnesses among other questions relating to their health and nutrition. RESULTS: About 85% PLWHA stated that they spend less on their nutrition and health because they are unemployed and unable to access funds from either the government or NGOs. CONLUSION: There is great need to improve the nutritional aspect of PLWHA by the state and NGOs. And also that they (government and NGOs) should make it possible for PLWHA to have access to ARVs. OP 12: HIV/AIDS RELATED STIGMA IN URBAN AND RURAL ZAMBIA Sichuundu, Watson, The University of Zambia, P.o. Box 32379, LUSAKA., ZAMBIA, Phone: +260- 097-822-970 Email: chilambe@zambia.co.zm BACKGROUND: In 2002, as part of a multi-country country study on HIV/AIDS stigma and resulting discrimination, qualitative research was conducted in poor communities in urban and rural Zambia. METHODS: Study sites were two high-density urban Lusaka compounds and Chief Mapanza’s area in Southern Province. 68 key-informant interviews and 25 FGDs were conducted with a broad and representative range of community members in both sites. FINDINGS: Stigma in the village was pushed away by witchcraft accusations – which assign blame to others and create hope – and by claims that AIDS could be cured or prevented through traditional medicines or prayer. Although witchcraft and traditional healing were also evident in town, other services, treatment options and training of traditional healers watered down their effects. In town, the language of stigma was harsher, overcrowding provoked gossip and health staff was more likely to stigmatize, but the variety of services and treatment options and increased access to IEC reduced stigma. CONCLUSIONS: HIV/AIDS is more easily managed in town and there is more HIV/AIDS stigma in the village, partly because of lack of interventions. OP 13: Does Poverty/Unemployment Speed the Rate of Transmission of HIV? “AIDS IS NEARER TO THE JOBLESS AND THE HUNGRY” Chris Zela Mudenda, University of Zambia, secretary general, Rescue mission Zambia, DOSA, P.O.Box 32379, Lusaka, Zambia. chrismudenda@yahoo.com AIDS never originated from Africa but today this continent features as the worst hit by this pandemic. All indicators highlight Africa as the poorest and highly eroded by poverty. Rising numbers of new HIV infections have been contributed by high levels of poverty and employment factors. Zambia for example, is one of the poorest countries in Africa and the introduction of Structure Adjustment Programmes (SAP) in 1991 led to the selling and liquidation of a number of all, once parastatal companies, but two to date. This situation sent hundreds of thousand Zambians, jobless and the situation is still ailing. Household income generation diminished for many families as efforts to try other money earning methods have been met with stiff, already established competitors as well as lots of other taxing factors. Mean time as the bad poverty levels in the ‘house’ continue to rise to worse many young girls to women have found a remedy that generates income faster than ever for them. Within minutes to hours of subjecting themselves to prostitution they have made more money per day than what their jobs offered. For those women not trading as ‘commercial’ sex workers the trend has been one where they have multiple boy friends, inclusive of married men, in a quest to cushion poverty levels. Currently even young girls as 11years have joined this stream as they vow to ‘live their lives alone’! Undoubtedly this trend has sped up the transmission of HIV as Southern African, especially Zambia bears enough witness. (250 words) OP 14: Does poverty/unemployment speed the rate of transmission of HIV? Antony Mwangi, P.O Box 1303 00606 NAIROBI, KENYA,Telephone: +254 722 981188, E-mail address: tknjoroge@yahoo.com , antony.mwangi@aiesec.net, tonnymwangi@hotmail.com, chairperson of AIESEC in Kenyatta University, Kenya. Poverty is a state of being poor, one is considered poor if his /her living standards falls below an acceptable norm according to the prevailing socio-cultural values in that society. Unemployment is the condition of having no paid job. A question arises; the definitions given above are they definite or relative? Whatever they are do they speed the rate of transmission of HIV? Yes! Transmission of this small deadly virus is through Body Fluids such as Sperm, Vagina Fluids and most dreaded Blood. It wouldn’t be so necessary to give statistics of AIDS and reveal that the most hard hit regions are those with high rate of unemployment and hence poverty, Sub Saharan Africa just to give an example. Unemployment renders people idle and bored, this in itself is a great danger following an old saying “IDLE MINDS ARE A SOURCE OF ALL EVILS”. It prompts people to engage in indiscriminate behaviors such as sex and drug dealing. Hopelessness in life leads people in engaging to drinking cheap liquor famously known as “kumi kumi” (ten ten) in my village which results in high rate of immortality. Prostitution has for a long time been associated with poverty, people have no alternatives to earn a basic living and hence sell their bodies for money and other favors. The overlap between poverty and poor public health has been well established. Lack of health facilities to treat STDs that increase HIV transmission, forced marriages just because of Dowry (and no attention is given on the status of the partner) are some of the results of poverty. Lack of education is more common in poverty stricken areas; it is lack of education that lead to irresponsible cultural behavior such as wife inheritance, unhealthy circumcision practices just to mention a few. Lack of Education has also led to insufficient knowledge of HIV transmission ways to citizens. Although there are numerous factors in the spread of HIV/AIDS it is largely recognized as a disease of poverty, hitting haddest where people are marginalised and suffering economic hardships. Poverty and unemployment eradication should be the number one priority to the African region since it has for a long time been a greatest cause of sufferings in our wonderful continent.
OP 15: INNOVATIVE APPROACHES TO FACILITATE HIV/AIDS AWARENESS, OPEN DISCUSSIONS & PREVENTION Leckson-Lecky, Gidion. T. Y., School Of Administration, University Of Ghana, P.O.Box LG25, Legion, Accra-Ghana. Issues Delivering of messages on STIs/HIV is becoming more difficult because of stigmatization on sexuality discussions in Ghanaian homes and schools. Innovative communications strategies must be used to initiate discussions in the homes and the classrooms. Description Games are universal and can be repeatedly played and used for activities to increase positive behavioral change on SRH, STIs, HIV/AIDS. Very successful in breaking the culture of silence on the above mention areas has been the use of the game and magazine. AYA-HIV/AIDS Games The game in the form of a monopoly was redesigned to impact general known and unknown knowledge on HIV/AIDS. The game takes the form of answering specific HIV questions at a particular point of the game. Wrong answer makes a player slides down in marks or stacks to a position, whilst the right answer makes a player climbs up with marks. Besides, there are scholarships and other awards to be won. The game supported with show and flash cards with correct answers and a manual, which comes in the form of intermediate and advanced players where 2, 4 individuals or groups could play. Interactions are encouraged as a group activity to generate further discussions. GHAYA Magazine This is a quarterly supplementary youth magazine, which targets policy makers, parents and teachers s an advocacy tool for open discussion of sexual Health. To encourage these discussions, the magazine focuses on challenging youth issues with regards to all SRH issues and youth development. It also encourage how to initiate discussion with parents and adults by children and the vice versa and among young people themselves. The game and magazine were pre-tested and officially launched in January and February 14, 2003 respectively and had tremendous response from parliamentarians, students, parents and rural kids Lessons learnt Over 3000 games, 10,000 magazines distributed to selected schools through the MOE, over 1,000s given to NGOS and CBOs and legislators. It has been noticed how young people if consulted or encouraged could come out with innovative ideas as both the magazine and the game are the principal ideas of young people. Both games and magazine are not mere recreation, but educational and every one have to be encouraged to question and discuss. Recommendation More popular games can be sourced locally and transformed into innovative educative materials OP 16: THE BIG SISTA / BRODA APPROACH: THE ROLE OF TERTIARY STUDENTS TOWARDS SECOND CYCLE STUDENTS Botchway, E.N. A., Dept. of Psychology, University of Ghana-Legon, P.O.Box MP 655, Mamprobi, Accra-Ghana. Issues Young people in the secondary schools by age 16 had had their first sexual intercourse as a result of negative peer pressure, lack of proper information etc. Though Family Life Education has been incorporated into the mainstream school curriculum, yet teachers find it difficult to handle the subject as they feel uncomfortable or they are not fully equipped to handle it. Most students have the zest and the quest for information and knowledge on issues relating to their reproductive health and total development. But they want it in a unique way. Description The BIG SISTA/BRODA approach by the RHESY FOUNDATION towards the creation of RHESY/FLE clubs in the secondary schools in Ghana uses the idea of getting young university students to interact with club members and the whole school on several issues including HIV/AIDS by sharing experiences and guidance through counseling and advice. The concept uses not only group discussion and counseling, but entertainment activities such as drama, film shows (yellow card), musical shows etc. Sometimes, the BSB approach uses quiz, debate competitions and occasional seminars where ministers of state have interacted with the students. Lessons The BSB approach has resulted in many students especially feeling comfortable to discuss reproductive health issues and HIV/AIDS among others. It has also stirred up their self-esteem. Some members have become youth resource persons working with the MOH/GHS ADH&D TOT programmes for doctors and health workers for the past 3 years. The members were also involved in the development of the MOH training manual. Stakeholders have realized the improved social and reproductive health lifestyles of the students and most of them becoming more responsible. Recommendations It is necessary to carry out more exciting programmes to attract more students on issues of HIV prevention. OP 17: A doomed generation Walyaro, Constance Georgina Khaendi, UNOY Peacebuilders, P.O.Box 65092, Ruaraka, Nairobi, Kenya 00618,comilia55@yahoo.com or constancegeorgina@yahoo.co.uk: Phone: 254 722 937102 or 254 722 489287 It has been said that we are the doomed generation; that we have never known a world without HIV/AIDS. And rightly so! We are in danger of being reduced to mere statistics. HIV is the 4th largest cause of death globally and the leading cause in Africa. Youth are most vulnerable, even more, young women. Discrimination and exclusion have hindered the efforts of many young people, seeking the type of counseling, testing, treatment and support that is required to ensure that those who are not infected remain uninfected, and the infected and affected are well cared for. HIV spreads fastest and widest in conditions of depravation, powerlessness and lack of resources, conditions in which many young people live. Many carry the virus for years without knowing, spreading it beyond their ‘high risk’ group to the broader youth population. AIDS is a social holocaust as well as a dilemma of individual behavior; yet the epidemic among youth remains largely invisible. Youth doesn’t mean immortality. Choose Life! We must remain committed; take it upon ourselves to lead the struggle against HIV/Aids; nothing less than our future is at stake. And there is still hope. A large-scale coordinated approach is recommended, with strong social and political mobilization at all levels, to develop youth focused strategies to address HIV/Aids. Strategies must address Discrimination and de-stigmatization, AIDS awareness & prevention, Youth friendly approach to healthcare provision, Outreach programs to involve street children, sex workers & orphans and Provision of life prolonging AntiRetroVirals OP 18: Richman’s problems Lyons-Fisher, Colleen, University of Pennsylvania School of Medicine, P.O. Box PO Box 672, New Hope, Pennsylvania, USA, Phone 215-794-2422, Clfisher@mail.med.upenn.edu The HIV/AIDS crisis is a healthcare crisis of historical proportions. The pandemic is ravaging the continent of Africa, leaving a path of social and economic destruction in its path. The moral implications of the disease are passionately debated in the global forums. Discussions of culpability and prevention have captured much of the debate. These topics should continue to be discussed but not at the expense of resource utilization to STOP THE SPREAD OF INFECTION. One of the consequences of globalization has been the illumination of disparity. The North, blessed with the abundance, is aware of the twin scourges of poverty and AIDS. Partner to that knowledge is the immediate duty to help alleviate the suffering. Within the bioethics community in the North, a few voices implore the mobilization of resource in order to fulfill that duty. However, the majority of time, money and energy of bioethics in the West is devoted to rich man’s problems: in vitro fertilization, sex selection, physician assisted suicide, cloning. These topics demand attention for the West but have no relevance for AIDS orphans and the millions who are dying due to poverty and disease. The duty to harness the innovation, intelligence and compassion of the American bioethics community, with partnership from developing nations students, implores that the issue of the HIV/AIDS, etc. become a required part of the curriculum of their degree programs. Every ounce of energy and penny of resource primary focus ought to be on the stopping the pandemic. A global alliance of International students and faculty would combine resource and mindshare of tremendous power OP 19: PREVALENCE OF SEXUALLY TRANSMITTED DISEASES (STD) AMONG URBAN FEMALE YOUTH IN OYO STATE (NIGERIA) Ajagunna O. Ayotunde, Department of Guidance and Counselling, University of Ibadan, Ibadan, Oyo State, Nigeria. The study examined the prevalence of sexually transmitted disease (STD) among urban female youth in Oyo State. Data from the medical records of 300 (female) subjects in two government owned hospital located in the state capital were analyzed. Results indicated the prevalence of STD (including AIDS) among urban female youth, aged between 13 and 17years old. The study also confirms that the unbridled sex activities by the female youth is in an attempt to keep the male youth loyal to them, but they always and up been used, by the male counterparts. The findings suggest therefore that comprehensive STD/HIV prevention programmes including training in assertiveness skills for females youth should be intensified in schools, and in our societies generally by using print and television media. OP 20: Etude de la séroprévalence du VIH/SIDA auprès de 50 orphelines du Sida à Brazzaville Julien Makaya, F.F Mboussou, T. Bansimba, L. Salami, INTRODUCTION Le problème des orphelins du sida constitue l’une des conséquences désastreuses du sida. Au Congo, on estime le nombre d’enfants ayant perdu leurs mères ou les deux parents à cause du sida à 64.000 depuis le début de l’épidémie. Les orphelins du sida constituent 46% des orphelins de toute cause. La précarité sociale a été observée chez ces orphelins. Précarité qui oblige les orphelines à pratiquer la prostitution de survie pour subvenir à leurs besoins. Celle-ci peut accentuer leur vulnérabilité face au VIH/SIDA, les exposant ainsi à la maladie de leurs défunts parents. Le but de ce travail est d’apprécier la séroprévalence du VIH/SIDA chez les orphelines du sida à Brazzaville. METHODES Dans le cadre du projet « prise en charge des orphelins du SIDA à Brazzaville » de l’O.N.G Médecins d’Afrique, financé par l’Unicef Congo, nous avons procédé au Counselling de prévention du VIH/SIDA auprès de 150 orphelines du sida, entre juin 2002 et janvier 2003. Ce counselling était mené par deux psychologues formés en technique de sida-counselling. Le conselling consistait à une série d’entretiens centrés autour de l’examen du comportement sexuel antérieur de l’orpheline. Nous avons également évalué la nouvelle situation sociale de chaque orpheline après le décès du /des parents. RESULTATS Sur un total de 150 orphelines du sida reçu en counselling, 79 ont décidé de faire le test de dépistage du VIH soit 52,66%. . Les orphelines étaient âgés de 12 à 18 ans dont 71 (soit 47,33 %) âgés de moins de 15 ans et 79 (soit 56,66 %) âgés de 15 à 18 ans. 99 adolescentes (soit 66 %) étaient orphelines des deux parents. 52 orphelines étaient chef de famille soit 34,66%. Sur un total de 50 orphelines qui ont passé le test de dépistage au Centre de Traitement Ambulatoire, 12 ont été révélée positive au VIH 1, soit (24%) Les orphelines séropositives ont été plus observées chez les orphelines de père et de mère : 8 cas (soit 66,66%) versus 4 cas (soit 33,33 %) chez les orphelines d’un parent. L’effectif des séropositives a été plus élevé dans la tranche d’age de 15 à 18 ans : 11 cas (soit 91,66%) versus 1 cas (soit 8, 33 %) dans la tranche d’age de 12 à 15 ans. L’age moyen des premiers rapports sexuels non protégés était de 13,5. Vingt (20) orphelines ont affirmé avoir déjà utilisé le préservatif. Mais celui-ci a été utilisé comme contraceptif dans 12 cas (soit 8%), de façon irrégulière dans les 39 autres cas soit 26%. Il n’y a eu aucun cas d’utilisation systématique du préservatif. Le nombre moyen des partenaires sexuels étaient de 7. CONCLUSION Outre les conséquences psychotraumatiques, la mort des parents du fait du sida a des répercussions sur la situation sociale des orphelins du sida. Dans ce travail, une séroprévalence élevée du VIH/SIDA a été observée chez un nombre non négligeable d’orphelines (24 %). Le multipartenariat a été observé (7 partenaires en moyenne). Il est par conséquent indispensable d’intégrer la prévention du VIH/SIDA dans les programmes de prise en charge des orphelins du sida. La prise en charge des orphelins représente à ce titre un nouveau défi pour le gouvernement, les agences internationales, les ONG et la communauté. Cet objectif vaut bien cet empreint de Claude Miollion (1988) à la pensée de Maximillien pour qui : « les bâtards sont innocents, ils sont malheureux, ils sont hommes, ils sont citoyens. L’humanité, la justice, l’intérêt public, tout impose à la patrie le devoir sacré de veiller efficacement à leur conservation. Les batars sont des citoyens sans reproches ». OP 21: WHAT WE MEAN BY ADOLESCENT FRIENDLY HEALTH SERVICES Bernard I.I. Sefu, Save the Children (UK), P. 0. Box 1267, ZANZIBAR., Tel: 0744 490707, E-mail bisefu@yahoo.co.uk The sexual and reproductive health service needs of adolescents are correspondingly heterogeneous. Adolescents who are not yet sexually active have different needs from those who are, and sexually active adolescents in stable monogamous relationships may need different types of services from those who engage in casual sex. Health care providers need to be aware of the diversity of sexual and reproductive health needs of adolescents and that adolescents are at risk, sometimes even more so, of developing the sorts of health problems that adults do, like anaemia and sexually transmitted infections (STIs). Adolescents who perceive themselves to be well are unlikely to seek health care, even if they need it. They may seek care at hospitals and clinics only if they are injured or suffer from conditions that are not related to sexual or reproductive health. Many factors underlie their lack of access to care. ISSUES Adolescents face a huge number of obstacles relating to the availability and accessibility as well as the acceptability of available services, which can inhibit them from accessing care from health facilities. Therefore to improve the availability, acceptability, accessibility and equity of services at point of delivery, ”Appropriate Youth Friendly intervention Programmes” needs to make sure that:- 1. adolescent-friendly policies are in place · That do not restrict the provision of health services on any terms, regardless of status. · That aim to fulfil the rights of adolescents. · that ensures the special need of different population segments/groups are taken into account (including those of particulary vulnerable and traditionally underserved groups). · that guarantee privacy, confidentiality, and promote autonomy. · that ensure free/affordable charges for services. 2. adolescent friendly procedures are put in place which facilitate · easy and confidential registration/ record keeping and retrieval. · short waiting time and quick referral where necessary. · consultation with or without appointment. 3. adolescent friendly health care providers are available who are technically competent · motivated and supported to work with adolescents. · non-judgmental and considerate, easy to relate to and trustworthy. · willing and able to devote adequate time to their clients/patients. · act in the best interests of their clients. · treat all their clients with equal care and respect, regardless of status. · provide adequate information and the needed support to enable all adolescents, to make free choices which are right for their unique individual needs. 4. adolescent friendly support staff (e.g. reception clerk) are available who are · understanding, considerate and treat all adolescent clients with equal care and respect, regardless of status, · competent, motivated and well supported 5. adolescent friendly health facilities with · no stigma. · appealing milieu. · convenient location. · safe environment. · convenient working hours. · Privacy. · offer informational and educational materials.
6. adolescent involvement is there, whereby they are · well informed about services on offer, their rights to services and are encouraged to respect the rights of others in their use of services. · actively involved in the assessment and provision of health services. CONCLUSION Therefore I conclude that, working together with adolescents, their families and communities and with health care providers and other stakeholders is essential if we want to encourage adolescents to use and benefit from health services. Experience tells us that strategies which promote positive community attitudes to health services and the importance of adolescent health may be essential when trying to increase service utilisation. Adolescents also need information about how and where to reach services. There is also consensus that if existing service-providers are networked and the coverage of government-run health facilities is extended and complemented through other channels, adolescents are more likely to obtain and use the services they need. Advocating to remove the economic, policy and legal barriers which prevent adolescents from using services is also necessary. RECOMMENDATIONS What we need to do to make AFHS happen - setting standards and defining actions necessary at different levels of service planning and delivery. Multi-level action Actions are needed at every level of health service planning, management and provision to deliver quality AFHS. From creating a positive policy and legal environment, developing standards and allocating funds to deliver a package of services at national level, to technical support for data collection and information management at district level, right down to training, supervision and the maintenance of quality improvement mechanisms at point of service delivery. OP 22: Access to treatment and care of HIV/AIDS patients Magret Elang, Mbarara University Of Science And Technology, elangmaggie@yahoo.com, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda. In Uganda, HIV/AIDS was first reported around the mid 1980’s, prior to 1987, AIDS cares was provided in only a few places, now there are over 50 AIDS care organizations and the number is increasing. These include government; mission hospitals and other non-governmental organizations offer services such as; Ø How care Ø Volunteer counseling and testing. Ø Medical care Ø Income generating activities Ø And social support. The government’s contributions towards access of care and drugs mainly involve promoting subsided drugs, setting up centers where registered HIV/AIDS patients come for follow up. However, not everyone is able to obtain the above either due to poor socioeconomic status, fear of stigmatization, ignorance etc so to address the above recently the health ministry a grant by funders announced that starting 2004 free HIV/AIDS drugs would be available even for the man at the grass root level. Much as there is hope for the grass root level man several shortcomings are being overloaded such as, Ø The period of sustenance with the drugs. Ø Development of multidrug resistance. Ø Inadequate prescriptions since most drugs are new. To address the above, Ø Proper sustained funding should be acquired to maintain the patient till death. Ø Specialised personnel should be trained to issue the drugs. Ø Proper follow up to avoid development of drug resistance. In conclusion, great thanks go to the government for the political goodwill and the non-governmental organizations for providing hope, love and care for the HIV/AIDS patients and their families. OP 23: REALITIES ABOUT HIV/AIDS Badjie, Bakary Y., National Association Of Youth And Children’s Organisations (Nayco), Tango Building Fajara M’ Section, P.O Box 3180 Serrekunda, Serrekunda, The Gambia, (220) 959803 Or (220) 390525, Rightful181@Hotmail.Com Or Nayco99@Hotmail.Com According to lessons in the Gambia and other parts of the world, the real origin of HIV/AIDS is not certain, but the virus was first diagnosed in San Francisco in the United State in 1981. Since then the virus has spread covering the whole world. The scientifically proven mode of transmission is through unprotected sexual intercourse with an infected person, blood transfusion, and use of contaminated piercing instrument and from parent to child transmission. When the HI Virus enters the body of a person through one of the ways mentioned above, its attacks the body immune system (white blood cells) and fight for about 10-15 years depending on person’s immune system before the person finally develops AIDS. In efforts of salvaging the world from the scourge of HIV/AIDS, many international and regional bodies have taken HIV/AIDS as propriety in all development plans. The UN Agencies had joint programs (UNAIDS) while the World Bank and other bodies have been providing funds for governments to fight AIDS and support PLWHA. HIV/AIDS has created many problems for the world especially Africa, these include education, health and agriculture. For example in some parts of south and east Africa, teachers, farmers and other skilled people die every day out of AIDS. This has a great impact on the society and economically, governments have invested a lot in fighting HIV/AIDS leaving other national priorities. Yet still many PLWHA don’t have access to care and treatment, the Anti Retroviral Drugs are very expensive for the ordinary Africans and this has created many setbacks in the fight against HIV/AIDS because PLWHA who could have been strong advocates die earlier than expected. In a recently ended conference in Senegal for “Home Base Care”, some countries such as Senegal and the Gambia promise to make available the ARDs for PLWHA OP 24: YOUTH OF THE UNITED NATIONS ASSOCIATION (YUNA) Daniel Bernard, Executive Committee member, Youth of United Nations Association, C/O UNDP Matasalamat Mansions Room No. 311, P.O.Box 9182 : Tel: 255-22-2121627; E-mail: unatz@raha.com Dar es Salaam. Is future still the same now? Of major concern in determining the future of youth of Africa is the increasing vulnerability. HIV/AIDS is the corner stone of vulnerability among youth. Its impact has been worsened by the existing social and economic problems already affecting the Tanzanian society. Poverty, food security, inadequate sanitation, subordination of women and girls and the global structural adjustment policies, which deny sufficient resources to the social sector. Under such conditions, many people are powerless to protect themselves against infections. Inadequate health facilities and poor nutritional status may further exacerbate the spread of HIV and accelerate the progression from HIV to full blown AIDS. Youth and HIV/AIDS No age group has suffered more from HIV/AIDS than youth. Not only are young people the most sexually active members of the society, but also the most energetic and productive. It not the question of youth versus HIV/AIDS anymore but society against this pandemic. If left unchecked the far reaching impact will challenge even the very existence of humanity itself. With the increasing impact of HIV/AIDS on number of orphans situation goes for worse again. Currently the number of orphan is estimated at 680,000. This army of children is soon coming to youth generation. The youth with no hope, no upbringing and ultimately no planned future. Again, many of these are HIV positive so they want to be taken care of by the society. Significant numbers of reproductive health service providers refuse services to adolescents or impose unnecessary restrictions. Most family-planning services tend to be attached to maternal and child health clinics which are the domain of older, married women with children. Unfriendly environment pushes more youth at risk of HIV infection, as the social support networks are not on their advantage. Is there a way forward? There is always a way forward but perhaps the fundamental question is as to whether it is the right way or is taking us to the wrong end. This is rather a difficult subject to deal with because it is about the unknown destination. Countries of Africa are in war day to day to fight poverty and related catastrophes- to this end the link between poverty and HIV/AIDS take its concrete form. Economic development plans at regional level such as NEPAD is Youth, Is there any Pragmatic Approach? There is no question that youth are the most affected social group from HIV/AIDS. From this unpleasant fact, it is true that the whole continent is affected by the unbearable loss of its work force, the very engine of development. That notwithstanding does the current strategies truly work and answers all the questions of young people? In the light of the circumstances, can youth redefine their future? In most areas of Africa youth have not gone to higher level of education and what is more they are not exposed to the sophisticated approaches. The true strategy is the inclusive one that leaves no one out from the start. Planners must be able to translate their planning language to the language understandable to the vulnerable and uneducated young women and men Conclusion We know better the burden we have, the vulnerability, the potentiality and our capacities. Let us then explore more in a way that calls for no donor funding as a prime condition. In a way and manner less sophisticated but relevant to our true will and feelings for change and protecting the future of our continent. African youth lead towards uncertain future, but thing can be changed for the better. It needs, as a fundamental requirement, our commitment. We ought to change life styles and lead more of transformative life changing social attitude and stereotypes related to HIV/AIDS. |
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