Salama SHIELD Foundation came into existence at the height of the HIV/AIDS pandemic. When we started working in southwestern Uganda, Lyantonde Town was referred to in the international press as the infamous long-distance truck stop where truckers and Commercial Sex Workers (CSWs) converged. Truckers would stop for night during their long trek from the port city of Mombasa in Kenya, traversing Uganda towards final destinations in Rwanda, Burundi, and the Democratic Republic of the Congo (DRC). Lyantonde had the highest incidence and prevalence for HIV transmission in the early 90’s. At that time, we began working out of a small stall (dukka) in town which had a sign over the door labelled Talking about AIDS. Our team elicited risk stories and identified the groups most at-risk for HIV: adolescent girls walking long distances to fetch water, mobile market traders, cattle loaders, and cooked food sellers. These larger groups were identified through our ethnographic research. It was a deeper problem than simply identifying long-distance truckers and CSWs as the principal groups at risk for HIV.
We began with revitalizing the social-cultural institution of the traditional mentor – paternal uncles (Kojja) and aunts (Ssengas) who had given up on their nephews and nieces. “Why bother”, they said, “we are all dying and getting finished!” Traditionally, these mentors educated and supported young people in matters of sexual and reproductive health, gender relations, marriage, and family life. SSF educated these mentors to augment their role in modifying HIV/AIDS behavioural concerns, a program that resulted in the reduction of HIV/AIDS incidence.
Over 356 Ssengas and Kojja (mentors) from Lyantonde and Rakai Districts have been trained to date in HIV/AIDS knowledge and risk behavior change.
Since then, we have expanded our health programs. We are now building and strengthening health systems in Lyantonde and neighboring Districts through our integrated approach. As such, SSF works together with government health care providers in addressing HIV/AIDS, TB, malaria prevention (eg., distribution of mosquito nets preventing malaria), sexual and reproduction health, and the prevention of mother-to-child transmission (HIV). Based on our previous intervention research in Zimbabwe and Malawi, we are advancing health programs that integrate indigenous knowledge systems on health with biomedical knowledge. This is a complex undertaking, as we bridge two distinct ways of knowing with the mind (indigenous and Western) through partnerships with traditional healers and faith/religious leaders. Yet in this innovative way, we demonstrate evidence of modified, behavioral change and the creation of healthy communities. When we started, persons in Lyantonde District were fatalistic: they are now more hopeful, believing that there is a progressive future made possible for their children.
Concurrently, children and youth are educated by SSF inside and outside of the classroom. In school, HIV/AIDS Educators receive training in how to effectively communicate to their students behavioral information on sexual health, sexually transmitted infections (STIs), sanitation and hygiene, and HIV testing and counseling. Outside of school, Ssengas and Kojja (mentors) guide young people in healthy lifestyle choices and behaviors. In addition to this social-cultural support, activities such as drama, dance, and sports sensitize young people on issues such as HIV/AIDS: they are engaged in discussions that encourage reduced risk in sexual relations, and leadership skills that allow youth to engage with their peers as “peer-to-peer” educators. These activities also help to facilitate community mobilization, participation, awareness, and the co-construction of culturally compelling educational protocols related to behavioral risk. Young people and children on school break are also invited to Salama SHIELD Foundation’s Community Development Centre (CDC) to participate in engaging, enabling, and empowering social events. We host youth talent shows, sports and music events, and dialogical events where they can openly and transparently discuss the problems they experience, as we collaborate together with them in the search for practical, behavioral solutions.
For adults, health programs are geared towards those most at risk such as commercial sex workers (CSWs) and their clients, as well as boda boda (motorcycle) and other taxi drivers. Partnerships have also been secured between the SSF Health team, local government, and formal medical institutions in the coordination of health care access, provision of essential services, and counseling to those who need it most – in town and in the rural areas. Mobile clinics are principally used in reaching remote, rural communities. Additional health care services provided by SSF include: mosquito net distribution, maternal and neonatal child health, awareness of gender-based and sexual violence, child abuse and neglect, eye clinics (with Canadian doctors), youth mentorship, couples counseling, and the promotion of condom use. Replicating our previous intervention work in Malawi and Zimbabwe, SSF conducts dialogical events with religious and cultural leaders on how best to communicate behavior change in the context of HIV/AIDS; their followers are also included in these conceptual events.
SSF has also sponsored advertisements on local radio stations to assist the community in preventing HIV/AIDS and TB. Multiple approaches to communication are especially voiced on World AIDS Day.
Finally, volunteers and interns (from local universities in Uganda and from Canada) have worked with young people in Lyantonde District on a number of our health and microfinance programs. One Canadian volunteer produced a song together with our Drama Group called Protect Love. It is a unique confluence of Ugandan and North American musical styles (alla: Paul Simon) and speaks to the issue of HIV prevention.