In-depth: HIV/AIDS in Southern Sudan

SUDAN: HIV/AIDS not as easy as ABC

Photo: IRIN
Awareness levels in Yambio County are relatively high
NAIROBI, 22 October 2003 (IRIN) - About 10 young adults gathered in a tiny room at the Equatorial United Youth Development Association (EUYDA) offices in Yambio, the major town in the Western Equatorial region of southern Sudan.

An interview with PlusNews had generated excitement among the group, and in an adjoining room a small choir was waiting to perform after the meeting.

EUYDA is a youth group at the forefront of the struggle against HIV/AIDS in Yambio County. It initiates awareness campaigns, runs a youth sports centre and coordinates activities among young people in the area.

"We are in a risky situation, especially the youth. We need help," said the chairman of EUYDA, James Severino. Dressed in a formal blue shirt and dark trousers, Severino sat facing everyone at the chairman's desk and invited the others to speak.

His assessment is borne out in the findings of a UN Development Programme knowledge survey on HIV/AIDS and sexually transmitted infections, carried out in December 1997 and January 1998.

The study showed that more than half of both men and women who tested positive in southern Sudan were between 20 and 29 years old. Sexual activity was found to begin at 10 to 14 years, and by the time girls reached the 15 to 19 age group, 45 percent were married.

It also found that about 41 percent of people had no knowledge of HIV/AIDS prevention methods. Condom use was low, unsafe sexual practices high, and sexually transmitted infections (STIs) occurred frequently but were treated sporadically. HIV infection was found to be highest in females.

Severino said although some communities "deep in the villages" did not believe HIV/AIDS existed, people living in town were getting the message disseminated through churches, at football matches, events such as music concerts, and on radio.

But EUYDA's administrator, Daniel Owudada, remarked that HIV/AIDS projects in Yambio were not moving fast enough. "NGOs are touching but not fully dealing with it. Not enough is being done - we are still far behind, and nowhere in line with the rest of the world."

Busu Juma Seme, EUYDA's coordinator for external affairs, pointed out that the standard ABC campaign messages were unrealistic for youngsters in the region. "Abstinence cannot happen in an illiterate community where people have sex early. 'Be faithful' is not going to happen, and 'condomise' - we are ready to use them, but we have no access to money."

Major Jerkuei, the oldest member of the group and a former soldier in the rebel Sudan People's Liberation Army (SPLA), was still not quite sure how condoms were used. His question: "How do you use them? Do they come in different sizes?" elicited a few embarrassed giggles from the group.

Condoms are not freely available, and at the price of 500 Ugandan shillings (25 cents) for a packet of three, are a luxury many cannot afford.

According to Bill Colford, an HIV/AIDS counselling trainer in Yambio, condoms are "a new thing in this area".

"People can spend that money on condoms or food ... they are not going to spend their food money on a piece of rubber," he said during a meeting with health NGOs working in the area.


Photo: IRIN
Yabongo Girl's Primary school in Yambio
The lack of testing facilities was another obstacle. "HIV testing is not yet available. We have a laboratory but we still need kits. We've been begging, crying for them," Matron Winnie Kayiwa told PlusNews during a visit to Yambio Civil Hospital. According to Severino, many young people had heard the messages during awareness campaigns and were now ready to act. "But, today, if I want to find out [my HIV status], where will I go? East Africa," he said.

Ambrose Sano Michael, the group's health coordinator, warned that introducing voluntary testing and counselling in southern Sudan would not be easy, as there was a still "a lot of fear" surrounding the disease.

"Somebody just can't go for testing because it means one thing: you are going find out whether you are going to die or not," he said. This, the group pointed out, was why it would be difficult to encourage people to be open about their HIV status - HIV/AIDS is still seen as a disease that kills.

AIDS messages on t-shirts and posters proclaiming that "AIDS Kills!" are a common sight in Yambio. Messages on living positively with HIV appear less frequently.

Poverty was another reason. "Our young sisters are getting infected just because of money. People are coming from Uganda, they dress well and can afford beers," Severino said.

The effects of war also made soldiers more vulnerable to HIV infection. "They [soldiers] have lost everything, they are frustrated. They don't care about getting AIDS," he added.

Conflict, fear and insecurity are nothing new for these war-affected youth. The mood became even more serious when they were asked about the future of the country.

"I grew up with the problems in southern Sudan - that's all I've ever known," Seme said solemnly. "But people are being killed by AIDS, not Arabs anymore," he added.

With peace talks offering an end to two decades of civil war, waged by the SPLA against the political and economic dominance of the largely Muslim and Arab north, the youth were hopeful that the tide could be turned against the epidemic.

"When peace comes, education [has to be] the first priority. The war denied us education, now AIDS is intervening. This must change," Owudade said.

Things are changing in Yambio, albeit slowly. In 2002 the UN Children's Fund (UNICEF) made strides in narrowing the gender gap in basic education in the area through the provision of evening classes for girls. The number of girls joining the evening classes has quadrupled, jumping from 1,241 girls in 2001 to 4,070 girls in 2002, a UNICEF report noted. Many of the girls attending the classes had previously dropped out of school, becoming young wives and mothers.

A growing restlessness from the group outside the office indicated that it was time for the performance. Seventeen-year-old Dona Zino was one of the few female group leaders who shepherded the younger children into neat rows before they started singing.

"What can we do to stop ourselves from HIV, which is now among us?" was the chorus of one of the songs.

This was a sign of hope, Colford pointed put. "People want information - they are crying and begging for it," he told PlusNews. And in the case of EUYDA, they are singing for it.
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