Our rationale for the establishment of the Salama SHIELD Foundation (SSF) emerged out of our HIV/AIDS anthropological research conducted during the height of the HIV/AIDS pandemic. When we started our behavioral research in Lyantonde, southwestern Uganda, the international press referenced only long distance truckers and Commercial Sex Workers (CSWs) as being at risk. Through our ongoing ethnographic research, we exposed a deeper, more troubling cohort of ethical and compelling concern.
Participatory action research (PAR) was conducted out of a small stall (dukka) in town. It had a sign over the door labelled Talking about AIDS. Our Ugandan team elicited risk stories and identified groups even more at-risk for HIV than truckers and CSWs — young girls walking long distances to fetch water at night, mobile market traders, cattle loaders, and cooked food sellers. Young women were at particular risk, living with choice-less choices, the consequence of gender inequities (“sugar daddies”), lack of educational opportunities, and poverty.
At that critical time in history (mid-nineties), the social-cultural institution of traditional mentors has unravelled. “Why bother with the young ones”, these mentors said, “when we are all dying and getting finished!” Paternal uncles (Kojja) and aunts (Ssengas) – were morally required to mentor their nephews and nieces in matters pertaining to sexual and reproductive health, gender relations, marriage, and family life. SSF revitalized this social-cultural institution, and augmented their role with training in HIV/AIDS behavioural messaging, which contributed to the reduction of HIV/AIDS incidence. At present, we are refreshing this intervention with modified behavioural training, given the fact that vulnerable persons are becoming more complacent in their risk reduction behaviours given easier access to anti-retroviral therapies (ARVs) which prolong life.
SSF is now strengthening other health systems in Lyantonde District through our integrated approach to health and development. We work with government health care providers in addressing not only HIV/AIDS, but TB, malaria prevention (eg., distribution of mosquito nets preventing malaria), sexual and reproductive health, and the prevention of mother-to-child transmission (HIV). Our interventions are innovative and morally imaginative, since we intentionally construct health programs that integrate indigenous wisdom 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.
When we started, persons and communities in Lyantonde District were fatalistic. They are now more hopeful, believing that there is a progressive, positive, and promising future for their children, families, and the community because of SSF’s “coming alongside them” as partners.