How one Tanzanian village is fighting AIDS

The village of Igabiro uses a unique community-based approach to fight AIDS – and it works.

Igabiro AIDS testing building
Tanzanians in the fishing village of Igabiro queue to get tested for HIV [Belinda Otas/Al Jazeera]

Today marks the 23rd anniversary of World AIDS Day, a milestone for a day long recognised globally as a symbol for heightened awareness about the impact of HIV/AIDS in the international community. Despite an apparent global media fatigue surrounding HIV/AIDS, activities to keep HIV/AIDS as part of global health discourse are taking place, and there is much to celebrate when it comes to the progress being made in certain regions of Africa. One particularly notable success is in Tanzania, where a community-oriented approach has been tackling a major national challenge.

In Igabiro, a fishing village that sits on the shores of Lake Victoria in Tanzania’s Kagera Region, 25 people are coming to terms with their newly discovered HIV-positive status on a particularly rainy November day. As music blares from loudspeakers in the village centre, which draws attention to the mobile testing site, men, women with children on their backs, and youths lined up to get their HIV test done. At first glance, this small, hilly, rocky fishing village is the most unlikely place to find queues of people who want to know their HIV status. A few years ago, the stigmatisation surrounding the HIV/AIDS epidemic in sub-Saharan Africa would have made this unheard of. Among the men and women waiting in line, their reason for getting tested is unanimous: They want to know whether or not they are infected.

The testing session is a community initiative organised and led by Tanzania Development and Aids Prevention (TADEPA), a local NGO that aims to improve the well-being of vulnerable groups. For the men, there is a prize to be collected after their fingers are jabbed for blood – they receive free condoms upon completion of their test – an incentive for some men to line up twice.

On that day, a total of 152 people were tested. TADEPA’s strategic use of testimonies by HIV-positive individuals living fulfilled and responsible lives has positively influenced villagers to find out whether they are infected. These individuals also serve as peer educators who travel through local villages to raise awareness about HIV. The community spirit that they foster in turn galvanises the people of Igabiro to come face-to-face with the reality of HIV/AIDS in their community.

Said Nehaja, a 49-year-old villager, was diagnosed with HIV in 1996. He told me it was very challenging because when he became aware he was HIV-positive, antiretroviral drugs (ARV) were not yet widely available in Tanzania. Nehaja says he only had access to Septrin, an antibiotic used to prevent pneumonia in particularly vulnerable HIV-infected people, until 2005. Before gaining access to ARV treatment, Nehaja’s CD4 count was 48, while the average count in someone who is HIV-negative varies between 600 to 1,200.

Stigmatisation was still heavily prevalent when he was diagnosed, and Nehaja admits that he also blamed himself: “I felt like the one who had failed the community, and that being HIV-positive was a crime.” He adds that his suffering, compounded by his lack of income, was insurmountable until the intervention of TADEPA brought him some hope in the form of ARV treatment. Since then, Nehaja has disclosed his condition to his family and friends, which he says has set him free and allowed him to become one of the peer educators at TADEPA who go out into the community and openly share their stories to encourage people to get tested.

Situated in the northwest corner of the country, Kagera is where the first HIV/AIDS cases in Tanzania were reported in 1983. The region borders Uganda, Rwanda, and Burundi. This makes Kagera, which is 98 per cent rural, a high-risk location, as its proximity to other migrating people puts its fishing communities at high risk of contracting HIV. According to the Tanzania HIV/AIDS and Malaria Indicator Survey of 2007/2008, approximately 200,000 new infections that occur each year stem from border populations. To make matters worse, border areas like the Kagera Region have limited access to HIV prevention, care and treatment.

Today, an estimated 1.4 million Tanzanians – just over 5 per cent of the population – are living with HIV/AIDS, says AVERT, a UK-based charity.

TADEPA has been an active player in the fight against HIV/AIDS in Kagera for the past 15 years. Its primary focus is the implementation of a community-based HIV/AIDS prevention and care project. Dr Jonathan Stephen, the executive director of TADEPA, explains that their programme addresses HIV/AIDS in vulnerable fishing communities and other hard-to-reach areas through prevention, community mobilisation, testing and voluntary counselling. In Igabiro, they currently work on educational initiatives, stigma reduction and nutrition promotion; they have also been conducting HIV testing in the village since 2009.

The positive results of TADEPA’s community-oriented initiatives are plain. Judging by the number of people who queued up, there are no secrets about who is infected. The shared belief is that everyone is vulnerable, and it is best if they all find out together. The long queues of men and women are empowering, as the villagers came out together without fear of stigmatisation. When compared to the approach in the Western world, where fear of HIV/AIDS seems to be subsiding, I wonder if the same number of people would openly come out in public view to get tested, especially if there were no celebrity to push the agenda.  

With ARV medication now easily accessible, people stand a chance of living longer than was conceivable a decade ago, an important development for a country with the fourth-largest HIV-positive population in the world. James Barongo Bashweka, TADEPA’s programme manager, estimates that 90 per cent of those diagnosed and referred to the Care and Treatment Centres comply with the course of their treatment. The treatment is complemented by a holistic approach to healthy eating developed by TADEPA, which trains people to produce their own food through its home gardening programme and emphasises the need for food security and the inclusion of vegetables in their daily diet as part of its efforts to improve the nutrition of people living with HIV.

Africa has always taken lessons from the rest of the world. Given what I witnessed in Igabiro, which showcases one of the most unique community-oriented approaches to HIV/AIDS, it is worth asking what the rest of the world can learn from the community spirit that is compelling people to take charge of their health. In November, US Secretary of State Hillary Clinton boldly declared that an AIDS-free generation could be achieved. If that dream is to come true, the world needs to rediscover what community is about. And there is no better place to draw that lesson than from Igabiro, Tanzania.

Belinda Otas is a freelance journalist, writer and blogger with a special focus on Africa. She contributes to The Africa Report and New African magazines and Think Africa Press. She is the assistant arts and features editor for the New African Woman magazine, where she writes extensively on women’s issues.

Follow her on Twitter @BelindaOtas.

The views expressed in this article are the author’s own and do not necessarily represent Al Jazeera’s editorial policy.