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NCU
Benin and
NCU
Congo
Small-scale
fisheries communities are the poor relation in HIV/AIDS prevention
programmes in Africa. However, given the conditions of migration and
poverty in which they live, these communities are extremely vulnerable to
the disease. In an attempt to reduce their vulnerability, a project has
been set up in small-scale fisheries communities in two countries, Benin
and Congo. The project includes a detailed survey in pilot villages to
assess the level of knowledge concerning the virus within fisheries
communities and people’s attitudes to the pandemic. The survey will make
it possible to increase awareness and social mobilisation, as well as,
eventually, to promote the better integration of these communities into
national HIV/AIDS control campaigns.
Acquired
immunodeficiency syndrome (AIDS) has become the most devastating disease
ever to affect humanity, UNAIDS recently stated. UN figures for 2002 show
that 42 million people in the world are infected with the virus, of whom
30 million live in Africa. Just twenty years after the terrible epidemic
first appeared, HIV/AIDS has become the prime cause of mortality in sub-Saharan
Africa, and is causing a real crisis in development. It affects future
generations – HIV/AIDS has already orphaned more than 13 million
children – and is a daily scourge to the economic and social fabric of
our societies, striking, as it does, the most productive age group. Most
new cases of infection are of 15 to 19 year olds, and more than half of
those are women.
Many
factors favour the propagation of HIV/AIDS in Africa. These include
increasing poverty, rampant urbanisation, the low level of women’s
emancipation, the weakness of national education systems, the poor level
of health care, migration, and many others, their relative importance
varying from country to country. Though figures to prove it are scarce,
fisheries has been identified as one of the highest risk sectors. The
reported HIV/AIDS situations in Benin and Congo differ, with the level of
HIV infection at 3.6% in Benin, but double that, at 7.2%, in Congo. The
more serious situation in Congo is mainly the result of the repeated wars
in the country over recent years, and the resultant massive population
movements, the surge in violence against women and girls, the
destructuring of the health care system, but also the collapse of HIV/AIDS
control policies.
However,
there are also many similarities between Benin and Congo. These include
the fact that HIV/AIDS control campaigns have scarcely even considered
small-scale fisheries communities, whilst concentrating mainly on the
large towns. But this sub-sector certainly deserves priority attention,
for at least two reasons.
Small-scale
fisheries, priority sub-sector
Firstly,
because it is the source of livelihood for a substantial part of the
population and a supplier of food to many others. In Benin, it is
estimated that small-scale fisheries provide a livelihood, either directly
or indirectly, for some 15% of the workforce, both men and women. The men
deal with the fishing itself, whilst the women are involved primarily in
fish processing and marketing. They also fish for oysters and crabs. In
Congo, the sector provides employment for between 7 and 10% of the
workforce, and inland fisheries is the main sector of economic or
subsistence activities. There is a huge national demand for fish, of which
small-scale fisheries meets approximately two-thirds. Given the
prohibitive price of meat, fish is the main source of animal protein, certainly for the poorest sectors of society. The loss of skills
and manpower has grave consequences for the coherence of communities and
implies great vulnerability for the survivors.
The
second obvious reason is that small-scale fisheries represents a high-risk
HIV/AIDS environment with the high levels of migration of fishers between
different countries providing an ideal vector for the spread of the
disease. The movement and seasonal availability of fish represents a
special kind of vulnerability to the people who live from it The
insecurity of their livelihoods means that the small-scale fishers of the
different countries of the West Coast of Africa migrate with the fish they
seek, their only source of income. These migrations take many forms, from
short migrations over medium distances within the country, to longer stays
in more distant lands. There are, for example, communities of Beninese
fishers in Congo, as well as in Gabon, Cameroon and Côte d’Ivoire,
countries where the HIV/AIDS infection rate is at least double that of
Benin. These migrations are not simple geographic movements but are a real
socio-cultural immersion, leading to new behaviours.
The
same project in the two countries
Given
these basic factors and reports of high HIV/AIDS incidence, the
Sustainable Fisheries Livelihoods Programme (SFLP) and the National
Coordination Units (NCUs) of Benin and Congo, felt it important to set up
an HIV/AIDS prevention project within small-scale fisheries communities.
In order to ensure compliance with the National AIDS Control Programme,
the UNAIDS approach was used to prepare and implement the SFLP project. In
both Benin and Congo, the project is intended to slow down the spread of
the disease, by introducing new behaviours to promote greater awareness,
through information and social mobilisation campaigns.
In
order to do this, the first thing is to assess the communities’ level of
knowledge, attitudes and practices towards HIV/AIDS, by conducting a
gender-sensitive survey. This is also an opportunity to help the fisheries
communities avoid the disease by improving their level of knowledge by
identifying high-risk local practices. The vulnerability and livelihoods
context will also be analysed, and its contribution to attitudes and
high-risk behaviour assessed. Then information, awareness-raising and
social mobilisation actions and activities will be introduced and/or
stepped up towards the prevention of HIV/AIDS – and other sexually
transmitted diseases – in the communities; other partners will also be
sought to provide support to the fisheries communities.
The
project will not attempt to reach all the small-scale fisheries
communities in the two countries. In Benin, 408 villages will ultimately
be targeted, mainly in the south of the country. These are rural
populations, most of whom live on the coast although some live around
lakes and rivers. Totalling about 600,000 people, they include sea-going
and lake fishers, fish vendors, input suppliers, boat builders, mechanics
and small traders. However, in the first instance, four sample villages,
two on lakes and two on the coast, will be directly contacted. In Congo,
the project will start smaller, dealing with three communities, one on the
River Congo and the two others on the coast, making a total of about 6,000
people.
In
both Benin and Congo, the project will be implemented by NGOs with long
and proven experience in activities for the prevention of HIV/AIDS. The
National Coordination Unit (NCU) of Benin has selected NGO Alternative.
The NCU of Congo on its part has selected NGO “Médecins d’Afrique”
which is to work in collaboration with the Makotipoko Development
Association (Association pour le Développement des Communautés de
Makotipoko - ADCM) for the Makotipoko area, and the Regional AIDS
Information and Prevention Agency (Agence Régionale d’Information et de
Prévention du SIDA - ARIPS) for Bas-Kouilou and Agip Base. It is
anticipated that “Médecins d’Afrique” the NGO that is currently
involved in the initiative on the Chari Oubangui-Congo River and is
working with the national AIDS strategy team will continue to support HIV
intervention in inland fisheries communities.
To
help the NCUs of Benin and Congo to better understand gender issues
related to HIV/AIDS and to improve the monitoring of results of the
knowledge, attitudes and practices survey, both of them have received a
copy of the “Gender and HIV/AIDS” document by Vicci Tallis (Bridge,
Institute of Development Studies).
A
participatory approach
Specifically,
the knowledge, attitudes and practices survey will be conducted in each of
the fisheries communities in order to determine the best way of reducing
these populations’ vulnerability, in terms of accessibility,
effectiveness and cost. Only then will the real HIV/AIDS control campaign
begin, through advocacy.
Since HIV/AIDS is a delicate and sensitive subject, there is no sense in going
straight into the community point-blank to try and deal with it. Advocacy
is an awareness-raising activity aimed at the opinion leaders and local
decision-makers. Beyond awareness-raising itself, the aim is to win the
agreement and actual and active involvement of the beneficiaries in the
local campaign against HIV/AIDS. This has to take account of aspects
related to gender and migration.
The
involvement and commitment of the opinion leaders and decision-makers in
each community will make it easier to ensure the projects’ truly
participatory approach, in particular because they will act as
“community relays” for the process. These “community relays” are
mainly volunteers, proposed by the opinion leaders and local
decision-makers, who will be involved in organising and conducting the
various stages of the project. They will be volunteers, but also health
workers, representatives of various associations or organs of the press,
and will all be given proper prior training. In this way,
awareness-raising and mobilisation will be ensured within each district,
each sector, each homestead and each community service, through
discussions, role-play or video shows.
This approach, involving as many people and sectors as possible, is
fundamental.
Since HIV/AIDS cncerns sexuality, a basic element of life, society and
culture, it cannot be fought, and still less beaten, by a one-off event.
It needs a process, which will take time and requires the participation of
the whole target population.
Continuing
the fight ....
Involving
all the actors in just one movement is one thing, but making sure that the
fight goes on, and even takes on greater dimensions, is quite another.
This can only be done in partnership with other projects and donors, but
also in compliance with the strategic guidelines of the government
concerned. For activities to continue, the resources must be made
available and the politicians also have to be informed and convinced. The
ultimate aim of the project is to ensure that small-scale fisheries
communities are truly included in the general HIV/AIDS control policy.·
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