Aids patients suffer as stigma rages in Somaliland

HARGEISA, Tuesday

When a young HIV-positive woman recently passed away in Hargeisa, capital of the self-declared republic of Somaliland, none of the women in her family volunteered to carry out the traditional Islamic rite of washing the body before burial.

“Her clothes are still hanging where she died because people think they can be affected if they touch them,” said Abdillahi Omar, a man in his 40s. Eventually, a group of HIV-positive women volunteered to wash the woman’s body.

Most people in Somalia still avoid touching or associating with people living with the virus.

“Each one of us who has announced that he or she has HIV/Aids was thrown out of his or her family. I was a soldier ... as soon as they got the information [about my HIV status], I was told not to enter the camp - they considered me as being the epidemic itself,” Mr Omar said.

“Our children are sent back home by the school administrators for no reason other than the fact that their parents have HIV ... we experience it daily,” said Amina Ali, a mother of four.

Experts attribute the intense stigmatisation of people living with the virus to ignorance and the strong association of HIV with immorality and ‘non-Muslim’ behaviour; United Nations estimates say less than 10 per cent of the population have accurate knowledge about HIV transmission.

“I know that HIV can be transmitted by using the same toothbrush as someone who is infected, or if the same [injection] needle used on an HIV-positive person is used on you,” said Sa’id Ahmed, a student at the University of Hargeisa. “If someone in my family had Aids ... of course I would feel the fear of the disease.”

Sexual intercourse is the main method of transmission in Somalia, but Ahmed did not mention sex as a way of transmitting HIV and there is no HIV education in schools.

“We have carried out a lot of awareness to reduce the stigma, as well as giving people information about how the disease transmitted,” said Hassan Omar Hagga, director of training at the Somaliland Aids Commission (SOLNAC) secretariat.

Somalia’s most recent progress report to the United Nations General Assembly Special Session on HIV/Aids noted that widespread stigma and discrimination were among the factors raising HIV vulnerability.

High stigma and low risk perception mean few people are tested for HIV, and the country’s antiretroviral (ARV) programme is still in its infancy.

“Of an estimated 13,000 people living with HIV in Somaliland, only 800 have access to ARVs,” said Mohamed Hussein Osman, executive director of SOLNAC.

SOLNAC has also been trying to push through parliament proposed legislation giving rights to people living with HIV, and making it illegal for doctors to reveal a patient’s HIV status without their permission.

“[The draft] law criminalises discrimination against the people who live with the disease, specifies their requirements for care, and stipulates punishments for those who try to deliberately transmit the virus,” said Hassan Omar Hagga.

Somaliland has an HIV prevalence of 1.4 per cent, but recent data suggest that the Horn of Africa could be moving from a concentrated epidemic to a generalised one.

In a conservative Muslim society such as Somalia, it is extremely rare for a person living with HIV to speak out.

But Mahamud Warsame, 53, from Galkayo in Mudug region of central Somalia, became an activist after his wife died of the disease. He spoke to IRIN on 14 December:

“I found out about my own status in May 2007 when I went to see a doctor who sent me to be tested. The results came back and the doctor informed me that I was HIV-positive. I honestly thought at the time that it was the end of the world for me. My wife also tested positive and she was devastated. She looked like the light went out of her.

“Friends and family disappeared as soon as they found out about our status. We had no support. Even though we were put on antiretroviral drugs, it did not help my wife because I think she just gave up. I looked after her for 8 months but she died in March 2009.

“The biggest problem we faced during this time was a lack of understanding and support from those closest to us.

“People would not rent their premises to us. People I have known for a long time would not even shake hands with me. I think that is what killed my wife, the isolation we suffered.

“After I buried my wife I decided to come out openly and tell people about my status and the fact that I was on medication and doing fine. I want to make sure no one has to go through what my wife and went through.

“We need to fight stigma and discrimination. I have already helped some men to go on treatment and not hide their status.

“Some people believe that because we are Muslims, we cannot contract HIV/Aids.

‘‘I tell them that it does not discriminate on the basis of religion, ethnicity or culture. Anyone and everyone can contract the virus.

“In this country we need to fight to dispel this false sense of security that Muslims don’t contract it and tell people we are all in this together.
“I am now on medication and those who don’t know me cannot even tell I am HIV positive.

I am working and trying to raise my two children who lost their mother. I think living with HIV has made me a better person.” (IRIN)