In 1997 one of the founder members Mrs Gertrude Lwanga attended a one year training in HIV Guiding and counseling in Uganda with The AIDS Support Organization (TASO) In 1998 this member started a support group for people living with HIV and AIDS at St. Mary’s hospital Mumias
She encountered many challenges within this group including those listed below:
- There were more women turning up than men,
- The men who came to the support group ended up dying faster than the women.
- High defaulter rate from the male side
- Widows were forced into wife inheritance or sexual cleansing by the clan members.
- Those who resisted were not allowed to: Shave their hair, Visit people’s homesteads including their relatives and neighbors’ homes.
- They were not allowed to share a meal with their male children, not allowed to shake hands with any man.
- Those who opted to be sexually cleansed feared to infect their sexual partners and tried to negotiate for condom use but the tradition did not accept the use of condoms in such a case.
- Many of the women conceived and their health deteriorated, eventually they died.
- With all the capacity building in the support group, women met a lot of resistance.
The worst challenge came when an elderly woman in the division died before being sexually cleansed and she had never been inherited. The clan insisted that the corpse be cleansed before anybody could dig the grave. This resulted in all the widows in the support group being inherited without using the condom.
There was a strong feeling that we needed to involve men and more so to re-examine the cultural practices before we can think of fighting the spread of HIV infection in this part of the country.
Approach to the provincial administration
Come 1999, The President declared AIDS a national disaster the office of the president was very vocal in sensitizing the community about AIDS. We did not miss this opportunity. Majority of the ruling chiefs in the current Mumias district were from the royal family of Chief Nabongo Mumia the King of Baluyia the Abashitsetse.
We consulted them and they requested senior chief James Rapando Wambani, now retired and one of the directors of MTAA to approach his father who was retired Chief William Wambani to give direction and support the initiative MTAA initiative
The year 200 was spend on situation analysis within the community
- By the beginning of the year 2001, MTAA organized the first workshop for key community leaders ( Gate keepers) Grand fathers
- Statistics from the hospital on how fast HIV infection was spreading in the District were shared and by that time the National HIV prevalence was 14% while Butere Mumias had recorded 10-12%
- Facts on HIV and AIDS were discussed
- Modes of transmission took the longest time as cultural practices involving contact with body fluids were stressed and this prompted the elders to explain how important their cultural practices were
- Impact of AIDS on family, community and country was shared in groups
- Prevention strategies were highlighted but when male condom was mentioned as a prevention strategy
Reactions from the Grand fathers
The elders felt offended and could not understand how a man can wear a polythene paper when relating with his wife sexually.
They believed that this could cause them to suffocate, loose erection and the wives would miss the vitamins in the seminal fluids.
The Gate keepers gave a stern warning that, No cultural practice would change unless there was an alternative to it
Gate keepers/ first generation listed all the clans existing in East wanga location and decided that two members be drawn from each clan to assist MTAA in listing down their cultural practices and recording their importance.
Second Generation workshop for clan implementing committees the fathers
For this workshop, 40 members were invited and we went through the same sessions as for the Gate keepers. It was observed that this group was different from the First Generation group.
They did not know why some cultural practices were performed. They kept on referring to the fact that it was according to their ancestors so they must appease those ancestors by fulfilling the cultural practices even if they posed such disasters as HIV infection
They accepted to go for voluntary counseling and testing, know their HIV status but were not going as couples neither were the men going to disclose their HIV status to their wives especially if they tested HIV positive.
The issue of Condom Use was discarded as in the first generation
Joint workshop for both fist and second generations
This workshop was planned by MTAA with an objective of reviewing what they had learnt and harmonizing the reports from both groups and get direction on sensitive issues like disclosure of HIV status to spouse, condom use where couples tested HIV positive or in discordant couples.
The issue of the virus in the body fluids was revisited and modes of transmission through both seminal and virginal fluid were stressed once more.
It was not possible to convince the men that condom use could reduce chances of infection
Although some of the men in the second generation accepted to use the condom if they knew that their wives were infected with HIV.
Asked to respond on what if they were infected, they said they would not let their wives know that they are HIV positive for fear that, culturally if you infect your wife with a venereal disease then you must be punished by paying extra cattle to her people.
For sexual cleansing, the condom was dismissed whether for it was for widows or widowers, but for inheritance the elders said it could be negotiable.
At this stage, we felt there was need to consult professional support from institutions of higher learning. One of our members was at the Great lakes University in Kisumu, We charged her with the responsibility of ensuring that professional support.
An academic research was carried out with the following objectives:
To determine how the changes in socio-cultural practices lead to risky sexual behavior in the community and identify the best structures and mechanisms in the change process
Specific objectives were:
- To identify traditional cultural practices that involve sexual practices and describe how they were practiced in the traditional times which was before the emergence of HIV and AIDS in the1980s.
- To identify and explain how traditional cultural practices as currently practiced may lead to risky sexual behavior
- To identify and describe structures and mechanisms that influence the practice of traditional cultural practices in the area
- To identify and describe socialization and training structures for the youth in both traditional and contemporary times
The key practices that were examined were Polygamy, Widow and widower sexual cleansing and remarriage, funeral rites, structures and mechanisms of molding the youth, circumcision and condom use.
All these were researched in the context of the traditional times and conventional time which meant the time before AIDS and after the emergence of AIDS.
The study adopted a descriptive qualitative methodology in its design because socio-cultural issues would need that discussants share their personal experiences and would give the researcher an opportunity to probe further
The focus groups that were interview were six. One group for older men above 50 years, one for men below 50 years, one for older women above 50 years ,one for women below 50years, a group for youth 20 years and below, one group for young girls 20 years and below There were Key informants apart from these groups