According to statistics, about 1.8% of the population of Hargeisa, capital of Somaliland, is HIV positive. So says Chris Jalle, family strengthening programme coordinator of SOS Children's Villages Somaliland, who also adds that, due to the stigma attached to the condition in Somaliland, many more cases go unreported. In fact the stigma is such that HIV/AIDS is seen as a curse on those who are infected. This in turn results in, at best, very little public information about the condition, and at worst, a complete denial that it exists in Somaliland.
HIV positive people are often ostracised
Aisha*, a widowed mother of four children, is HIV positive and was ostracised by her family when they found out. Her first husband died and she married again, but when her second husband discovered her condition he abandoned her and her children. So Aisha moved away from the security of her family and community and lives with her four children in a house made from bits of cardboard, old sacks, pieces of corrugated iron, fragments of PVC groundsheet and branches from trees. Considering the material, it is surprisingly well built and the only light inside comes through the slit of the door.
Aisha has lived in this dwelling for two and a half years with the support of an organisation called Talowadag, which is a coalition of community-based projects dealing with HIV/AIDS. The SOS Family Strengthening Programme (FSP) in Hargeisa has partnered with Talowadag, and with their help Aisha and her family were identified as an urgent case in need of medical and social support. While anti-retroviral drugs are supplied free to Aisha by a Hargeisa hospital, she is now able to receive free medical care at the SOS Medical Centre, for opportunistic infections that often afflict HIV positive people. Her children too receive free medical care.
Traditional birth attendants to be trained
The SOS Social and Medical Centre Hargeisa opened in June 2008 and is the most modern clinic in the town. With nine full time staff, two part time doctors and several well qualified volunteers, it is currently looking after 65 families with 387 children registered in the family strengthening programme. For those not on the programme it is primarily a mother and child clinic, giving ante and post natal care, together with an 'under fives' programme which monitors growth and, in partnership with UNICEF, offers free immunization.
In January 2009 the baby delivery room will also be operational. At the moment 90% of deliveries are carried out at home, so it is anticipated that only the complicated cases will come to the medical centre. However, a traditional birth attendant will be attached to the centre and it is planned to train more of them to assist in home deliveries. As in the SOS Mother and Child Clinic in Mogadishu, all deliveries will be free while other standard services will cost the equivalent of a 50 US cents registration fee.
Medical centre very popular in Hargeisa
Chris Jalle relates that on the day of opening about 150 patients came from all over Hargeisa for treatment and the staff found it difficult to cope. "Now the patients are restricted to neighbouring areas and FSP beneficiaries', he says, and we have stabilized at 40 to 50 patients a day".
The social and medical centre also includes a voluntary counselling and testing centre, meant to provide counselling for all needs, but particularly HIV/AIDS, a laboratory, an observation room, a pharmacy and the above mentioned immunization programme. "Somaliland has lowest coverage of immunization in the world", states Chris Jalle, "so we really want to focus on this."
With this sort of support at least Aisha and her family's medical needs will be met and as a beneficiary of the FSP, she will also be trained in income generating skills and supported with start-up funds, which should eventually help her improve her living conditions.
By acknowledging and confronting her illness, despite losing the support and love of her family, Aisha has been recognised as a needy beneficiary of the SOS FSP and is managing to keep her little family together. Cultural attitudes may prevent other women from asking for help and changing attitudes will take time, but Chris Jalle is confident that by June 2009, 1, 000 children will be supported by the SOS Family Strengthening Programme at the SOS Social and Medical Centre Hargeisa, while many more from the community will be treated on a daily basis.
*Name has been changed for privacy reasons.