Title: Integrating HIV and AIDS Initiatives to overcome Cultural

Barriers

Presented By: Daniel Ole Naikuni

TOUCH OF LOVE INT.DEV.PROGNAROK

TOLIDP at a glance

TOLIDP is a Christian non-for-profit community-based organization for human rights, community health and development, registered in 2001.

Vision

TOLIDP envisages a healthy, just and prosperous society

Mission Statement

To Promote a Maasai Pastoralist community whose livelihoods are secured through faith in God, improved human rights & governance, healthy lifestyles and sustainable community based development

Goals and Objective

• To share the gospel of Jesus Christ.

• To empower the Maasai pastoralist community on their fundamental human rights and governance for effective participation in social action

• To promote a healthy community through improved and enhanced knowledge on health and nutrition with implementation of an integrated health intervention program

• To promote sustainable livelihoods through resource mobilization, economic empowerment, education, environmental conservation and community development.

Core strategic issues

• Health and Nutrition – HIV and AIDS, TB, Malaria, FP, RH…. In partnership with APHIA II Rift Valley project.

• Livelihoods :- Water provision for domestic and livestock consumption - Girl child education

• Human Rights and Governance - Land rights and natural resource access & management - Environmental concerns - Tolidp Institutional Capacity building - Human and resource development

Area of operation

TOLIDP operates in the larger Narok district (North and South)

Demographic profilePopulation 403,000 (M:203,000;F:200,000)

CultureNomadic pastoralists

Economy 64% live below poverty line (70 women)Major cash crop is wheatMain business is livestock tradeOthers: charcoal burning,

Information Limited connectivity HIV and AIDS prevalence 7%

TOLIDP’s integrated Health intervention:

TOLDP has been implementing a prevention program targeting Most At Risk Population (MARPS) among the Maasai pastoralist of Narok district. The specific groups targeted include; - Livestock traders and livestock drivers - Women Support Services providers - Cultural Manyatta Morans - Commercial Sex Workers

Cultural Barriers

The Maasai society, like any other traditional African community has its own traditional customs and practices that may enhance the infection rate.

1. Polygamy

• This is still highly practiced and stands out as one of the leading predisposing factors to the spread of HIV/AIDS. The rural women feel that they have no control over their sexual lives, as there are too many stakeholders within their lives.

2. Sharing of cutting objects

• - FGM and Circumcision-Home deliveries (85% approx)

3. Culturally sanctioned immorality

The non-sexually aggressive morans are given insulting name i.e. 'Osinoni' and are looked down upon and ridiculed by peers and society.

4. Women fertility ceremonies

While in pursuit of "children" the women are granted liberty to search from whoever within the "ritualistic-month(s)". The young adults are fully aware of this 'opportunity' and do utilize it. The repercussions for this are rather obvious.

5. The young adults'

graduation.

• ceremonies are held annually to upgrade them to higher cadres of junior elderhood. As they recruit others they more often than not indulge in irresponsible sexual behaviors which catapult the rate of spread of HIV/AIDS.

6. Age set wives

• Wives sharing among age mates though reduced but still exist and this propel the spread of HIV/AIDS.

7.The abhorrent use of family control methods

• The community due to a lack of exposure and awareness employs negligible methods if any of the "safe' sex e.g. condoms which would have otherwise reduced the risks.

8.Traditional medicine men/women

• The medicine person (enkayukoni) at times treats the patient by way of making incisions through the skin, an exercise that might prove to be very dangerous in this age of HIV/AIDS.

8. Gender based violence

• Women in many communities have no say of when to have sex.

Approaches employed:

This is unique and original intervention isolating certain traditional hidden institutions /populations hitherto unreached with the HIV and AIDS prevention message(s). The groups were previously unreached due to a combination of many factors ranging from, geographical remoteness of their habitat, illiteracy, traditional and cultural orientations, lack of local grass roots based organization with the capacity and commitment to address their concerns, absence/inaccessibility of Health services, among other constraints.

1. Traveling Theatre Groups are empowered to carry out

community outreaches through training on Magnet theatre and Puppetry in the eleven livestock Markets.

The message and means of communication is thus localized and made culturally sensitive and easily acceptable. The MT performances during market outreaches have always elicited lively discussion among community participants with enormous potential for behavior change.

2. Mobile VCT services

• undertaken in collaboration with either the Ministry of Health or Pillar of Hope. This has been another appropriate approach to this mobile pastoral community.

3. Peer Education and buddy grouping.

• The PE were empowered with the expanded health information and the idea of being My Brother’s Keeper’ through buddy group formation was utilized.

4.The Women support service providers.

• They are trained in PE and are busy reaching out to their colleagues in the market place and at the homesteads.

Synergetic benefits from other partners:

• The other APHIA II projects in the district provide a complimentary role in the intervention strategy thus enhancing maximum project impacts.

1.Narok District Network Forum

• reaches to the traditional Age-set leaders who are the custodian of cultural and traditional practices.

2. Enaitoti Biashara

• reaches out the traditional low income rural Maasai women, including the wives of the livestock traders.

3.Wolrd Vision Channels of Hope

• reaching out to church congregations

Program impact:

• There is a reported concern by CSWs of reduced business a trend partly attributable to change in behavior among livestock traders.

• There is high increase of condoms demand by Peer Educators due to high consumption. an indication of changed attitude towards condom use.

• The trained Morans in cultural Manyattas in Maasai Mara have also become distribution outlets for condoms and some have actually integrated the HIV/AIDS Health information in on-going ‘Adult Literacy’ classes at the Manyatta and into their traditional songs and dance.

• Some Women service support providers have embarked on Wheat farming to address the underlying causes of vulnerability.

Challenges and limitations

• Geographical inaccessibility of the Area.

• Illiteracy.• Traditions and cultural customs• Inaccessibility of Health services.• Large scope of operation.

Conclusion and Recommendations• Build the capacity of our target audience-

training livestock traders as peer educators, market based MT groups…

• Develop murals that portray health messages - Illiteracy.

• Involving Cultural leaders as advocates-Traditions and cultural customs

• Enforce Linkages between the community and Health services.

• Sensitizing both men and women in the community on gender rights-GBV

Morans Peer Educators at Maasai Mara.

Moonlight Vct services

Csw’s peer educators in a weekly session.

Livestock traders in the market