Tanzania is an east African nation roughly twice the size of California. Recent UNAIDS estimates show that HIV cases in the country have remained steady since 2001, with women being more infected than men (7.7 percent vs. 6.3 percent). Nearly 10 percent of Tanzanian women aged 25 to 34 years have HIV.
The country has a high incidence of tuberculosis (TB), with approximately 52 percent of TB patients co-infected with HIV, according to UNAIDS. Malaria is prevalent, as are food- or water-borne diseases such as bacterial diarrhea, hepatitis A, and typhoid fever. Tanzania also has had outbreaks of measles, plague, and Rift Valley Fever.
NIAID supports several projects in Tanzania related to HIV/AIDS, including studies on antiretroviral therapies, behavioral interventions, and control of sexually transmitted diseases. NIAID also funds research on TB and malaria, particularly severe malaria in Tanzanian children.
KIWAKKUKI Encourages Community Involvement To Fight HIV/AIDS in Tanzania
"If you can empower a woman, you can do a lot. Women will work freely and tirelessly. Women will involve their neighbors." These are the words of an employee at KIWAKKUKI, an organization taking its name from the abbreviation for a Swahili phrase meaning, “Women aggressively fighting HIV/AIDS.” “Aggressively” might be an understatement, considering that the group’s staff members work seven days a week to give HIV/AIDS a human face in their community.
KIWAKKUKI was founded in 1990 by women living in Moshi, a small town near the base of Mt. Kilimanjaro in northern Tanzania. The group was registered as a non-governmental organization in 1995 and has 44 employees and more than 6,000 members. KIWAKKUKI receives 90 percent of its funding from international donors, including NIAID, and 10 percent of its funding from the sales of local handicrafts and goods.
The women of KIWAKKUKI have a vision to create a community that takes appropriate measures to stop HIV/AIDS while contributing to efforts to mitigate the disease’s effects.
Partnering With Science
KIWAKKUKI receives funding from NIAID, in partnership with Kilimanjaro Christian Medical Centre, Kibongoto National Tuberculosis Hospital, and Duke University Medical Center, to conduct clinical studies on AIDS-associated co-infections and the care of HIV/AIDS patients.The KIWAKKUKI role often involves community involvement, such as distributing questionnaires, and penetrates deep into rural villages.
Bringing Families Together
In Africa, heterosexual transmission is responsible for the majority of new HIV cases. To get families talking about HIV/AIDS, KIWAKKUKI hosts events where families can attend and discuss the disease in groups in which they feel safe: men together, women together, parents with their children, and youth with other youth.
Counselors walk HIV-positive caregivers through the process of revealing their status to their children, helping them not to be afraid but to become cooperative participants in their parents’ care. KIWAKKUKI also encourages mothers and fathers who are dying of AIDS-related illnesses to create memory books for their children that they will leave behind when they die. Since 2005, more than 1,170 memory books have been written by caregivers for their children.
Helping Those in Need
In 1998, KIWAKKUKI began providing continuous support, including food, shelter, medicine, education assistance, and skill-building and recreational activities to orphans and vulnerable children impacted by HIV/AIDS. The group usually helps several thousand children each year. Several children helped by the group in its early years are currently attending or have graduated from college. Many of them have returned to work in their communities, supporting KIWAKKUKI.
Since 1998, the group has built 36 houses to shelter very needy children, such as those who live alone with no adults. In these cases, neighbors contribute building materials so that the community partially owns the house. KIWAKKUKI also provides loans to families caring for orphaned children and has built eight playgrounds.
Since 2006, the KIWAKKUKI Positive Outcomes for Orphans program, which receives NIAID funding, has interviewed 500 children to assess the quality of their food, shelter, and care.
Protecting the Survivors
Sometimes, when a woman’s husband or a girl’s father dies from HIV/AIDS, his surviving relatives will disown or refuse to support her. In Tanzanian culture, property is considered to belong to men only. A woman has access to property only while her husband or father is living; she loses this access after a death or divorce. Although the Tanzanian legal system provides formal protection against such circumstances, few women, especially in rural areas, are aware of or able to enforce their rights.
KIWAKKUKI has partnered with non-governmental human rights and HIV support organizations to counteract property confiscation by in-laws or the refusal of male relatives to care for female members orphaned or widowed by HIV/AIDS. By bringing families together to create viable wills, the organization prevents women from being sent from their homes after their husbands or fathers die. The culture is slowly changing as HIV-positive parents legally declare that their children, regardless of gender, will have their land after their deaths. When women’s property and inheritance rights are upheld, they are better able to mitigate the negative economic and social consequences of HIV/AIDS.
Providing a Human Touch
The African custom of neighbors visiting each other shines through the KIWAKKUKI home-based care (HBC) program. The home visits include basic nursing care and social, spiritual, and nutritional support. These interactions exemplify the Swahili greeting, “Shikamo,” which is often reserved for elders and means, “I hold your feet.” HBC workers literally hold the feet of their HIV-infected neighbors to check for pain, sores, and other complications of HIV/AIDS. The HBC workers’ consistent friendship can also be a lifeline to their neighbors. Violet Kessy, KIWAKKUKI district coordinator, described how one man she visited at first did not want to take anti-retroviral medication because he had lost his will to live. After listening to her repeated advice, he changed his mind and now is able to farm his land again.
One of the motivational signs hanging in KIWAKKUKI’s office proclaims: “No one can do everything, but everyone can do something.” The women of KIWAKKUKI have taken this advice to heart, and the results are showing.