Reaching the handicapped with HIV prevention in Mozambique
TETE, 11 January 2010 (PlusNews) - Stefania*, 17, who has been wheelchair-bound since being involved in a traffic accident as a child, likes to go to Celso's, a popular bar in Matundo, a suburb of Tete city in northwestern Mozambique.
From her vantage point at Celso's she can see the long line of trucks waiting to cross the Zambezi River on one of the few bridges in the region, making Matundo a busy hub for people and merchandise travelling between the port of Beira and Malawi.
Adult HIV prevalence in Mozambique is 16 percent, but what Stefania knows about the disease she has had to learn through her own observations.
"I come here to relax, and I see lots of girls getting into the trucks," she told IRIN/PlusNews. "Some of them have become pregnant, and two of my neighbours have fallen very ill, so having a lot of lovers can end in disgrace."
The World Health Organization (WHO) estimates that 10 percent of Mozambique's 20 million inhabitants have some form of disability, but HIV prevention campaigns have so far ignored the fact that young disabled people are also at risk of infection. The Ministry of Health has put the number of HIV-positive handicapped Mozambicans at around 324,000.
A 2007 study involving children and young people between 11 and 23 years of age with and without disabilities, by Miracles in Mozambique (MIM), a missionary organization, found that a lack of educational opportunities for disabled people meant they also lacked information about HIV/AIDS, and were especially vulnerable to infection at the beginning of their sexual lives.
Just 10 percent of the disabled respondents knew the difference between the virus (HIV) and the disease (AIDS), and only four percent knew the symptoms of AIDS.
"I know HIV/AIDS exists," said Stefania. "You can get infected by kissing or having sexual relations with someone who's very sick. Other than that, I don't know any other ways of getting infected."
The MIM study also revealed that AIDS campaigns did not take into account some of the basic needs of those living with handicaps by, for example, using sign language to reach the hearing impaired, or publishing information in oversized type or Braille for the visually impaired.
"We've registered cases of sexual abuse against disabled people," said Sérgio Reis, president of the Mozambican Association of Youths With Disabilities (AJUDEMO) in Tete.
"There is still a low level of knowledge about the disease, which is allied to the campaigns' lack of effectiveness. People with disabilities are a part of this world and are also victims of the misfortunes that befall this society."
Educating to inform
AJUDEMO has been working with various partners in Tete and the neighbouring city of Moatize to include people living with disabilities in AIDS initiatives and turn them into activists.
"The activists are trained and given the task of identifying other handicapped people in their neighbourhoods, and planning interventions based on their individual needs and capacities," said Reis.
Conversations with the intellectually handicapped are kept simple and direct, sign language interpreters design programmes for the deaf, and the blind are taught how to handle condoms. The activists also help disabled people overcome structural barriers at medical centres so that they can access HIV counselling, testing and treatment.
Handicap International, in partnership with the Forum of Mozambican Associations for the Disabled (FAMOD), has also advocated the construction of ramps to ease access to health facilities for the wheelchair-bound. Income-generation projects to reduce begging - which makes disabled people even more vulnerable - are also being set up.
The Tete Sports Association for Disabled People is using tournaments and musical shows to reach disabled people with messages about HIV and AIDS. Ilton Qualquer, an association member, said many disabled people attended and participated in the tournaments, and felt more at ease in expressing themselves at such events.
Stefania was eager for more information, commenting: "If I had knowledge and were trained as an AIDS activist, I would help a lot of girls from my neighbourhood and other disabled people to take care of themselves and lead a healthy life."
*Not her real name