A close-up perspective on Aids in Nigeria

Emily Price, a young Ballyea primary school teacher, who recently returned from Nigeria where she worked as a volunteer among people with HIV and Aids, shares her experiences

IT IS a fairly common experience for teachers in Ennis to have children in their class from Nigeria and other Sub-Saharan African countries. When I heard I had won a travel award to visit Nigeria, I was pleased to get the opportunity to learn more about the life experiences of some of my pupils. EIL Intercultural Learning, the organisation who gave me the award, is an Irish not for profit organisation, which provides intercultural learning opportunities for about 2,000 people annually.
I set off for Nigeria with very little idea of what to expect. Like most people in Ireland, I was aware of the unrest in Nigeria and my perception was that it could be a dangerous country but nothing could have prepared me for the wonderful warm welcome I received. I was immediately stuck by the eagerness of everyone I met to make my stay in Nigeria worthwhile.
Almost everybody in the country speaks English but Yoruba is the tribal language spoken in the south-west where I stayed. An aspect of Nigerian life, which took some getting used to, is the passion that people display when they communicate. In most conversations people would greet each other warmly, shout at one another, talk animatedly and laugh.
I travelled extensively in the south-west and with other volunteers to Kano in the north of the country. The transport consists of okadas (Chinese-made mixtures of scooters and scramblers that are as noisy as vuvuzelas) and minibuses that are so riddled with rust that a heavy rain may cause them to melt into the mud below. The only time I felt unsafe throughout my visit was when these vehicles danced dangerously around oncoming traffic due to the potholes that engulf half of the road. Believe me, it puts a whole new perspective on complaining about the state of Irish roads.
Since Nigeria is the most populous country in Africa, with a population of 154.7 million (UN, 2009), it is an extremely diverse country. The people identify themselves primarily through their tribe, rather than nationality. It is a bit like Irish people closely identifying with their county but on a much larger scale. Ireland’s presence in Nigeria is unmistakable, from the GAA tops donated by Irish charities that adorn the children on the street to the newly constructed HIV/Aids clinics and orphanages and, of course, the Guinness signs which are seen everywhere.
I worked with Living Hope Care, an organisation that provides care and support for people living with HIV and Aids and orphaned and vulnerable children. There were 33.4 million people living with HIV at the end of 2008 (UNAIDS). EIL provided me with training before I travelled, during which time I learnt that being HIV positive, or having HIV disease, is not the same as having AIDS. Many people are HIV positive but don’t get sick for many years. As the HIV disease continues, it slowly wears down the immune system. Without treatment, two-thirds of adults infected with HIV are likely to develop Aids within 10 years of being exposed to HIV. Unfortunately, in Nigeria this period is much shorter, as people are exposed to tuberculosis and parasitic diseases such as malaria.
Antiretroviral (ARV) medication can prolong the time between HIV infection and the onset of Aids. Unfortunately, as I learned in Nigeria, these medicines are not widely available in poorer countries around the world and millions of people who cannot access the medication continue to die. The clear message from the training is as relevant to people in Ireland as those in Nigeria. It is important for people to know their HIV status and to protect themselves and others from this virus. The only reliable way to discover if you are HIV positive is to get a blood test, which can detect infection from a few weeks after the virus first entered the body.
Those of us who have access to information regarding HIV/Aids have a duty to use this information in order to reduce the spread of the disease in Ireland.
This can be such a simple task for Irish people when compared to the experience of Shaio, an amazing volunteer with Living Hope Care. She herself was living positively with HIV and had suffered unbelievable prejudice from the community as a result. When she was pregnant, she was aware of her HIV status and was determined to take precautions to protect her unborn baby from contracting the virus. However, when she was in labour she was refused entry to a maternity clinic because they were aware of her status. She then travelled to another clinic and in order to save her baby’s life, she withheld her status from the mid-wife. Throughout the labour she ensured that the mid-wife took all the necessary precautions to protect herself and the baby. The delivery was successful and a few hours after giving birth, Shaio washed all the surfaces and the bed and equipment with the bleach she had brought in order to protect others from the virus. She later ensured that the midwife received training from Living Hope Care on HIV and Aids.
Others I met travel over an hour, crammed into old buses on treacherous roads, to receive their ARVs, check-ups and to have secondary infections, such as TB, treated, as there is nowhere in their state that provides the drugs. At the hospital, those with TB and other air-borne diseases are required to wait outside in the unbearable heat.
Once, at night, we had to rush to the hospital where a mother lay exhausted, malnourished and frantic for her baby to receive the drugs, which are more effective the sooner they are administered. The baby had been born a few weeks premature and because of the poor conditions of the maternity clinic, was going to have to vacate the bed and building within a few hours.
Another experience that will always stay with me is the time I had to rush to a run-down maternity health clinic to administer drugs to a baby born to a mother who was HIV positive. These drugs are ARV prophylaxis drugs, which means that they attempt to prevent mother-to-child transmission of HIV. The reason our NGO had to deliver this treatment was that the maternity clinics did not have access to the drugs, as they are not provided by the State. Therefore, it was necessary to travel to a hospital in a neighbouring state to register during pregnancy to receive the drugs. Our NGO kept the drugs until the baby was delivered, as they must be stored in a fridge, something most our clients did not otherwise have access to. In Ireland, this baby would have been in an incubator. However, in Nigeria it was sent away from the overcrowded and understaffed maternity clinic despite its vulnerability.
This experience brought home to me in a very real way the inequalities of access to healthcare. Poor people receive poor treatment. In the Global South, one-third of women have HIV positive babies (UNAIDS). Sadly, it has been recorded that “An estimated 500,000 mothers die from pregnancy-related causes each year; at least eight million suffer life-long health problems linked to pregnancy and childbirth”.
Every two weeks, regardless of how sick our clients were, it was necessary for them to spend an entire day travelling and waiting at the state hospital in the city of Ibadon to receive their drugs. While waiting to see the doctor, I asked a woman if I could take her photograph, after she had spoken to me about her life story.
“Once she said I could, I took my camera out of my bag and immediately chaos ensued as the group of about 30 people sitting with us jumped up and ran out of view. I reassured the group that I would not take any photographs, as aside from this woman, nobody else wanted anyone to learn of their HIV status. This fear was a result of living in a community and a world, which stigmatises those living with HIV/Aids.
Nelson Mandela said, “Many people suffering from Aids are not killed by the disease itself. They are killed by the stigma and discrimination surrounding everybody who has HIV and Aids.”

Emily recommends that anyone interested in overseas voluntary work should check EIL’s website at www.eilireland.org/.