In-depth: Winning the peace: The challenge of AIDS in post-war countries

RWANDA: Handling HIV/AIDS in an active army

KIGALI, 7 February 2007 (IRIN In-Depth) - Rwanda's small but potent army has been active beyond its borders in recent years, fighting in neighbouring Democratic Republic of Congo (DRC) and peacekeeping in Sudan's Darfur region.

Originally based on a guerrilla force formed by exiles in Uganda, it marched into Rwanda in 1990. Four years later it had battled its way into the capital, Kigali, ending a campaign of genocide launched by a Rwandan interim government aimed at the minority Tutsi population and moderate Hutus.

In a region with a relatively high HIV prevalence, the military has trained its soldiers in AIDS prevention for more than a decade as part of a broader response to national security.

"In the 1990s, when the many of the soldiers in the current army came from Uganda, we had a serious problem with HIV - very many of our men were infected," Dr Charles Murego, director of medical services in the Ministry of Defence, told IRIN/PlusNews. "Prevention activities began seriously in 1995 and we began giving HIV-positive soldiers ... [treatment] in 1997."

The army's prevention efforts are evident at the Ministry of Defence headquarters in Kigali, where billboards urge soldiers to condomise and volunteer for HIV testing. Murego said the the Rwanda Defence Force (RDF's) HIV programme was based on three key principles: Knowledge, Attitude and Practice, known as KAP.

"We sensitise our soldiers about HIV from the top to the lowest levels, even the president [of Rwanda, Paul Kagame] has been involved in AIDS education for the army," he added. "According to our surveys, about 85 percent of soldiers have responded positively to KAP and have changed their attitude and behaviour. Prevalence in the RDF was estimated at between two and three percent - slightly lower than the infection rate in the general population.

Armed with a high level of awareness, units had returned from deployment in the DRC without increasing the incidence of HIV infection. Murego cited a recent focus group meeting where 10 soldiers were randomly selected and asked if they were carrying condoms: eight out of 10 were, one had forgotten his, and one said he had abstained from sex since losing his sister to an AIDS-related illness.
 
Part of the KAP programme was instilling a sense of compassion for HIV-positive comrades, as stigma remained a problem. "We do not stop soldiers from training or developing within the army, just because they are infected," Murego said. "The only operations HIV-positive soldiers are prevented from participating in are peacekeeping operations."

The military are currently demobilising and absorbing thousands of ex-rebels and soldiers of the former government, who fought against the RDF in eastern DRC. "For the army soldiers, we do not need to do much work - they had been trained in the army's HIV programmes," said Alphonse Nkusi, chief operations officer of the Rwanda Demobilisation and Reintegration Commission. "The ones we concentrate on are former rebels."

Rebels arrived and were counselled about HIV at several border points the commission had between Rwanda and the DRC. "We encourage them to go for tests and if they are found positive, we support them to form unions or join existing groups of people living with HIV," Nkusi said.

"We educate but do not test former child rebels, in accordance with international guidelines, but they are encouraged to get tested following demobilisation," he said. "Many have been put at risk of HIV during their time as soldiers."

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Winning the peace The challenge of AIDS in post-war countries February 2007 C O N T E N T S Lead Feature Home sweet home? Features AIDS and rubbers - Firestone rolls into action Expanding health care new post-war challenge Handling HIV/AIDS in an active army Reluctant HIV-positive refugees urged to return home Sex, drugs and HIV Trauma counselling vital to recovery from sexual violence In-Depth Feedback PlusNews welcomes feedback. Send your messages to feedback.

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